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Recurrent meningitis due to epidermoid.

Cherian A, Baheti NN, Easwar HV, Nair DS, Iype T - J Pediatr Neurosci (2012)

Bottom Line: Aseptic meningitis is characterized by noninfective serous inflammation of the meninges.It can occur in a recurrent fashion when associated with dermoid and epidermoid cysts due to rupture of cyst contents into subarachnoid space resulting in aseptic chemical meningitis.Bacterial meningitis in association with these tumors is commonly related to a coexisting dermal sinus tract and the most common organism is Staphylococcus aureus.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Government Medical College Trivandrum, Kerala, India.

ABSTRACT
Aseptic meningitis is characterized by noninfective serous inflammation of the meninges. It can occur in a recurrent fashion when associated with dermoid and epidermoid cysts due to rupture of cyst contents into subarachnoid space resulting in aseptic chemical meningitis. Bacterial meningitis in association with these tumors is commonly related to a coexisting dermal sinus tract and the most common organism is Staphylococcus aureus.

No MeSH data available.


Related in: MedlinePlus

Computed tomography shows a hypodense (2-20 Hounsfield Unit) cyst seen in front of the brain stem in the premedullary cistern lifting the basilar artery (arrow), with flattening of the anterior surface of medulla (arrow head)
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Figure 1: Computed tomography shows a hypodense (2-20 Hounsfield Unit) cyst seen in front of the brain stem in the premedullary cistern lifting the basilar artery (arrow), with flattening of the anterior surface of medulla (arrow head)

Mentions: Her first such episode was at 3 years and 2 months of age for which she was treated elsewhere as “pyogenic meningitis” with antibiotics after a cerebrospinal fluid (CSF) study which was culture negative. She improved only to have a similar recurrence 4 months later. Since she had recurrent meningitis, computed tomography (CT) of the head with contrast was done which was initially reported as “normal.” Her complement levels (C3 and C4) and immunoglobulin (including IgG subclass) assays were normal and her retroviral status and vasculitis workup were negative. She was given pneumococcal vaccine and was discharged after which her third similar episode occurred. She never had seizures, altered sensorium or trauma. Examination was normal except for terminal neck stiffness. In view of recurrent meningitis CSF leak was thought of and CT myelocisternography was done which did not reveal any bony defect. Reevaluation of the old CT showed a hypodense (2-20 Hounsfield Unit) cyst seen in front of the brain stem, with minimal flattening of the anterior surface of medulla which was initially missed [Figure 1]. Magnetic resonance imaging (MRI) with spectroscopy confirmed the presence of an epidermoid cyst in the premedullary cistern [Figure 2] with a prominent lipid peak. She underwent a near-total excision of the lesion and histopathology confirmed an epidermoid cyst. The patient completed a 2-year follow-up and is event free.


Recurrent meningitis due to epidermoid.

Cherian A, Baheti NN, Easwar HV, Nair DS, Iype T - J Pediatr Neurosci (2012)

Computed tomography shows a hypodense (2-20 Hounsfield Unit) cyst seen in front of the brain stem in the premedullary cistern lifting the basilar artery (arrow), with flattening of the anterior surface of medulla (arrow head)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3401655&req=5

Figure 1: Computed tomography shows a hypodense (2-20 Hounsfield Unit) cyst seen in front of the brain stem in the premedullary cistern lifting the basilar artery (arrow), with flattening of the anterior surface of medulla (arrow head)
Mentions: Her first such episode was at 3 years and 2 months of age for which she was treated elsewhere as “pyogenic meningitis” with antibiotics after a cerebrospinal fluid (CSF) study which was culture negative. She improved only to have a similar recurrence 4 months later. Since she had recurrent meningitis, computed tomography (CT) of the head with contrast was done which was initially reported as “normal.” Her complement levels (C3 and C4) and immunoglobulin (including IgG subclass) assays were normal and her retroviral status and vasculitis workup were negative. She was given pneumococcal vaccine and was discharged after which her third similar episode occurred. She never had seizures, altered sensorium or trauma. Examination was normal except for terminal neck stiffness. In view of recurrent meningitis CSF leak was thought of and CT myelocisternography was done which did not reveal any bony defect. Reevaluation of the old CT showed a hypodense (2-20 Hounsfield Unit) cyst seen in front of the brain stem, with minimal flattening of the anterior surface of medulla which was initially missed [Figure 1]. Magnetic resonance imaging (MRI) with spectroscopy confirmed the presence of an epidermoid cyst in the premedullary cistern [Figure 2] with a prominent lipid peak. She underwent a near-total excision of the lesion and histopathology confirmed an epidermoid cyst. The patient completed a 2-year follow-up and is event free.

Bottom Line: Aseptic meningitis is characterized by noninfective serous inflammation of the meninges.It can occur in a recurrent fashion when associated with dermoid and epidermoid cysts due to rupture of cyst contents into subarachnoid space resulting in aseptic chemical meningitis.Bacterial meningitis in association with these tumors is commonly related to a coexisting dermal sinus tract and the most common organism is Staphylococcus aureus.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Government Medical College Trivandrum, Kerala, India.

ABSTRACT
Aseptic meningitis is characterized by noninfective serous inflammation of the meninges. It can occur in a recurrent fashion when associated with dermoid and epidermoid cysts due to rupture of cyst contents into subarachnoid space resulting in aseptic chemical meningitis. Bacterial meningitis in association with these tumors is commonly related to a coexisting dermal sinus tract and the most common organism is Staphylococcus aureus.

No MeSH data available.


Related in: MedlinePlus