CASE REPORT
Difficulties in the diagnosis of meningitis – a challenging case of a child with head injury
More details
Hide details
1
Student Research Association of Paediatric Emergency Medicine, Medical University, Warsaw, Poland
2
Department of Emergency Medical Services, Faculty of Health Sciences, Medical University, Warsaw, Poland
Corresponding author
Jan Stachurski
Department of Emergency Medical Services, Faculty of Health Sciences, Medical University of Warsaw, Litewska 14/16, 00-575, Warsaw, Poland
J Pre Clin Clin Res. 2022;16(1):6-8
KEYWORDS
TOPICS
ABSTRACT
Meningitis is a potentially life-threatening condition. The clinical manifestation can vary depending on the age of the child.
This report presents the case of a 7-year-old male patient who was admitted to ED due to loss of consciousness after a
head injury. Upon admission, the patient had seizures. Head CT scan did not show any signs of intracerebral bleeding or
cerebral oedema. During hospitalization in the ICU, the patient began to be febrile and inflammatory markers started to
rise. Treatment with antibiotics and antiviral agents was administered. Later, meningeal signs were observed. Additional
imaging tests revealed ambiguous findings. The patient’s symptoms resolved gradually, and he was discharged after 19
days of hospitalization. The final diagnosis was meningitis. This case highlights that the diagnosis of meningitis requires
careful investigation and precise examination. This diagnosis should therefore be considered in all patients who present
with symptoms concerning for meningitis.
Gregorczyk M, Stachurski J. Difficulties in the diagnosis of meningitis – a challenging case of a child with head injury. J Pre-Clin Clin Res.
2022; 16(1): 6–8. doi: 10.26444/jpccr/145567
REFERENCES (15)
1.
Ochocka P, Zbrzeźniak J, Paradowska-Stankiewicz I. Meningitis and encephalitis in Poland in 2019. Przegl Epidemiol. 2021; 75(2): 215–228.
https://doi.org/10.32394/pe.75....
2.
Okarska-Napierała M, Kuchar E. Zapalenie opon mózgowo-rdzeniowych u dzieci – postępowanie praktyczne. Standardy Medyczne Pediatria. 2017; 14: 241–250.
3.
Akaishi T, Kobayashi J, Abe M, et al. Sensitivity and specificity of meningeal signs in patients with meningitis. J Gen Fam Med. 2019; 20(5): 193–198.
https://doi.org/10.1002/jgf2.2....
4.
Mount HR, Boyle SD. Aseptic and Bacterial Meningitis: Evaluation, Treatment, and Prevention. Am Fam Physician. 2017; 96(5): 314–322.
5.
Ciechanowska M, Stachurski J. Differentiating stroke, transient ischemic attack, or hemiplegic migraine in a teenager: a case report. Med Sci Pulse. 2021; 15(3): 44–48.
https://doi.org/10.5604/01.300....
6.
Starobrat G, Taczała J, Fatyga M, et al. Posttraumatic Epidural Haematoma in a child with severe haemophilia A – case study. J Pre-Clin Clin Res. 2019; 13(2): 76–78.
https://doi.org/10.26444/jpccr....
7.
Bodilsen J, Dalager-Pedersen M, Schønheyder HC, et al. Time to antibiotic therapy and outcome in bacterial meningitis: a Danish population-based cohort study. BMC Infect Dis. 2016; 392(16). https:// doi.org/10.1186/s12879-016-1711-z.
8.
Gałuszka DM, Poznańska A, Kunecki M, et al. Meningitis – case report. Emerg Med Serv. 2019; 6(3): 225–232.
https://doi.org/10.36740/ EmeMS201903106.
9.
Shukla B, Aguilera EA, Salazar L, et al. Aseptic meningitis in adults and children: Diagnostic and management challenges. J Clin Viro. 2017; 94:110–114.
https://doi.org/ 10.1016/j.jcv.2017.07.016.
10.
Toczylowski K, Bojkiewicz E, Barszcz M, et al. Etiology, Clinical Presentation and Incidence of Infectious Meningitis and Encephalitis in Polish Children. J Clin Med. 2020; 9(8).
https://doi.org/10.3390/jcm908....
11.
Johansson Kostenniemi U, Norman D, Borgstrom M, et al. The clinical presentation of acute bacterial meningitis varies with age, sex and duration of illness. Acta Paediatr. 2015; 104(11): 1117–1124.
https://doi. org/10.1111/apa.13149.
12.
Alamarat Z, Hasbun R. Management of Acute Bacterial Meningitis in Children. Infect Drug Resist. 2020; 13: 4077–4089.
https://doi. org/10.2147/IDR.S240162.
13.
Kaur H, Betances, EM, Perera TB. Aseptic Meningitis. Treasure Island (FL): StatPearls Publishing, 2021.
14.
El Shorbagy HH, Barseem NF, Abdelghani WE, et al. The value of serum procalcitonin in acute meningitis in children. J Clin Neurosci. 2018; 56: 28–33.
https://doi.org/10.1016/j.jocn....
15.
Julián-Jiménez A, Morales-Casado M. Utilidad de las determinaciones analíticas en sangre y líquido cefalorraquídeo para predecir meningitis bacterianas en el servicio de urgencias. Neurología. 2019; 34(2): 105–113.
https://doi.org/10.1016/j.nrl.....