Rapidly fatal pneumococcal meningitis following non-penetrating traumatic brain injury.
Accidents, Traffic
Anti-Bacterial Agents
/ therapeutic use
Brain Injuries, Traumatic
/ diagnostic imaging
Dexamethasone
/ therapeutic use
Diagnosis, Differential
Fatal Outcome
Glucocorticoids
/ therapeutic use
Humans
Male
Meningitis, Pneumococcal
/ drug therapy
Pneumocephalus
/ diagnostic imaging
Skull Fractures
/ diagnostic imaging
Young Adult
adult intensive care
meningitis
neurological injury
trauma CNS/PNS
Journal
BMJ case reports
ISSN: 1757-790X
Titre abrégé: BMJ Case Rep
Pays: England
ID NLM: 101526291
Informations de publication
Date de publication:
17 Feb 2020
17 Feb 2020
Historique:
entrez:
20
2
2020
pubmed:
20
2
2020
medline:
3
11
2020
Statut:
epublish
Résumé
A previously healthy young man presented to hospital with severe traumatic brain injury following a motor vehicle collision. Within 24 hours of admission, and despite antibiotic coverage, he developed a fever. On the second day, the source of infection was discovered to be purulent pneumococcal meningitis. At 48 hours post-accident, he developed brain-stem death without evidence of raised intracranial pressure or trans-tentorial herniation. Initial CT scans of the head were essentially normal, but early repeat scans revealed evidence of pneumocephalus and possible frontal bone fracture. Current recommendations do not make room for targeted antibiotic prophylaxis in traumatic brain injury patients with traumatic skull fracture. We argue that our case demonstrates the need for aggressive targeted antibiotic prophylaxis in the presence of certain features such as frontal or sphenoid bone fracture and pneumocephalus.
Identifiants
pubmed: 32071126
pii: 13/2/e232692
doi: 10.1136/bcr-2019-232692
pmc: PMC7046397
pii:
doi:
Substances chimiques
Anti-Bacterial Agents
0
Glucocorticoids
0
Dexamethasone
7S5I7G3JQL
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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