Basilar Meningitis Associated With Ethmoid and Sphenoid Cephaloceles

• Published in: Pediatric neurology Vol. 33; no. 1; pp. 57 - 60
• Main Authors: Khwaja, Omar S., Robson, Caroline D., McManus, Michael L., Urion, David K.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-07-2005; Elsevier
• Subjects: Adolescent; Bacterial diseases; Bacterial diseases of the nervous system. Bacterial myositis; Basilar Membrane - microbiology; Basilar Membrane - pathology; Biological and medical sciences; Ethmoid Bone - microbiology; Ethmoid Bone - pathology; Human bacterial diseases; Humans; Infectious diseases; Male; Medical sciences; Meningitis, Bacterial - diagnosis; Meningitis, Bacterial - microbiology; Neurology; Pneumococcal Infections - diagnosis; Pneumococcal Infections - microbiology; Sphenoid Bone - microbiology; Sphenoid Bone - pathology; Staphylococcal infections, streptococcal infections, pneumococcal infections; Sphenoid; Meningitis; Nervous system diseases; Ethmoid; Central nervous system disease
• ISSN: 0887-8994; 1873-5150
• DOI: 10.1016/j.pediatrneurol.2005.01.014

Nontuberculous causes of basilar meningitis are rare. This study presents the case of a male who developed fever and meningitis caused by
Streptococcus pneumoniae. He developed multiple cranial nerve palsies and imaging findings consistent with basilar meningitis and ventriculitis. Computed tomographic scans of the floor of the anterior fossa were performed after the detection of a cephalocele on magnetic resonance imaging. This imaging revealed a defect in the cribiform plate and fovea ethmoidalis with a large nasoethmoidal cephalocele. There was a second separate defect and cephalocele involving the middle cranial fossa. The association of basilar meningitis with an atypical organism should lead to a careful search for disruption in the floor of the anterior or middle cranial fossa.