Acute Hydrocephalus Associated with Streptococcus anginosus Meningitis

  • Masako Sakurai Department of Emergency and Critical Care Medicine, Tokyo Medical University, Tokyo, Japan
  • Takashi Watari General Medicine Center, Shimane University, Shimane, Japan; Division of Hospital Medicine, University of Michigan Health System, Ann Arbor, MI, USA
  • Itaru Nakamura Department of Infection Prevention and Control, Tokyo Medical University, Tokyo, Japan
  • Kazunari Azuma  Department of Emergency and Critical Care Medicine, Tokyo Medical University, Tokyo, Japan
  • Hiroshi Homma Department of Emergency and Critical Care Medicine, Tokyo Medical University, Tokyo, Japan

Keywords

Acute hydrocephalus, bacterial meningitis, non-obstructive hydrocephalus, obstructive hydrocephalus, septic shock, Streptococcus anginosus

Abstract

Introduction: Meningitis-related acute hydrocephalus is rare, challenging to diagnose, and has a high mortality rate. 

Case description: Here we describe the case of a 76-year-old patient diagnosed with bacterial meningitis who developed acute hydrocephalus and subsequently died. 

Discussion: Although meningitis-related acute hydrocephalus is usually non-occlusive, occlusive hydrocephalus may also occur. Moreover, worsening hydrocephalus despite cerebrospinal fluid drainage should prompt a diagnosis of obstructive hydrocephalus. In such conditions, potential management strategies include ventriculoperitoneal shunt and endoscopic third ventriculostomy.

Conclusion: In patients with meningitis-related hydrocephalus, worsening despite appropriate antibiotic administration, treatment may be complicated by ventriculitis and obstructive hydrocephalus, which can be fatal. If intracranial pressure is not medically controlled, bilateral decompression craniectomy should be considered as a potential management strategy.

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  • Published: 2022-11-22

    Issue: 2022: LATEST ONLINE (view)

    Section: Articles

    How to cite:
    1.
    Sakurai M, Watari T, Nakamura I, Azuma K, Homma H. Acute Hydrocephalus Associated with Streptococcus anginosus Meningitis. EJCRIM 2022;doi:10.12890/2022_003653.