Displasia de Mondini asociada a meningitis bacteriana recurrente, correlación clínico-imagenológica / Mondini dysplasia associated to recurrent bacterial meningitis-a clinical and imaging correlation

Se describe la displasia de Mondini asociada a pérdida auditiva y meningitis bacteriana recurrente. La malformación de Mondini representa el 30 por ciento de las anomalías congénitas del oído interno, puede ser unilateral o bilateral, y su principal característica consiste en el desarrollo coclear incompleto, causante de grados variables de hipoacusia neurosensorial. Se considera que la ocurrencia de esta malformación se produce por disrupción del desarrollo embrionario durante la séptima semana de gestación, en la cual se detiene el desarrollo coclear. Se presenta el caso de una niña de 12 años, atendida en los Servicios de Pediatría y Otorrinolaringología del Hospital Pediátrico Universitario William Soler, por presentar 3 infecciones meningoencefálicas, en las cuales se aisló Streptococcus pneumoniae serotipo 19F, y se constató hipoacusia neurosensorial severa en el oído izquierdo. La tomografía axial computarizada de alta resolución del oído (cortes axiales y coronales), evidenció la malformación coclear y vestibular, con presencia de tejido en el oído medio que se comunicaba directamente con el oído interno del lado izquierdo a nivel de la ventana oval. Se destaca la importancia de la sospecha clínica de displasia de Mondini, y el impacto científico de la tomografía computarizada del hueso temporal, para el diagnóstico precoz de fístula congénita en el oído interno asociada a meningitis bacteriana recurrente

Mondini dysplasia associated to hearing loss and recurrent bacterial meningitis was described in this paper. Mondini malformation accounts for 30 percent of congenital anomalies in the inner ear, either unilateral or bilateral, and its main characteristic is the incomplete cochlear development causing various grades of neurosensory hypoacusis. It is considered that the occurrence of this malformation results from the disruption of the embryonal development on the 7th week of gestation when the cochlear development ceases. This is the case of 12 years-old girl who was attended to at the pediatric and otorhinolaryngology service of William Soler" university pediatric hospital because she presented with three meningoencephalic infections from which Streptococcus pneumonia serotype 19F was isolated. It was also confirmed that she suffered severe neurosensory hypoacusis in her left ear. High-resolution computerized axial tomography of the ear (axial and coronal planes) evinced the cochlear and vestibular malformation, with tissue of the middle ear communicating directly with the inner ear of the left size at the oval window. This paper underlined the importance of the clinical suspicion of Mondini disease, and the scientific impact of the computerized axial tomography of the temporal bone in order to early diagnose the congenital fistula in the inner ear associated to recurrent bacterial meningitis

A case of Spontaneous Transsphenoidal Encephalocele with Recurrent Bacterial Meningitis / 대한소아신경학회지

Encephaloceles are congenital defects in the skull through which menings and brain tissues herniated. Basal encephaloceles are found in 1 in 40,000 live births. Transsphenoidal basal encephaloceles are very rare, accounting for only 5% of all basal encephaloceles. Currently, most encephaloceles are diagnosed antenatally and present at birth. Postnatally, infants may present with CSF rhinorrhea, recurrent meningitis, headache, hypothalamic- pituitary dysfunction. Some, particularly trasnssphenoidal encephaloceles are often clinically occult and diagnosis of the disease may be postponed up to adulthood. Surgical indications and approaches for transsphenoidal encephaloceles have been remained controversial. We report a case of CSF rhinorrhea and recurrent meningitis caused by transsphenoidal encephalocele.

A Case of Recurrent Bacterial Meningitis associated with Traumatic Cerebrospinal Fluid Fistula / 감염

Recurrent bacterial meningitis in adults is a rare disease mostly due to traumatic cerebrospinal fluid (CSF) fistula and usually occurs within 2 weeks after head trauma. Recurrent bacterial meningitis shows high mortality and requires prompt diagnosis and proper treatment. However, diagnostic problems often arise when there may be no recent history of head injury, no direct radiologic evidence, and no CSF rhinorrhea or otorrhea. A 43-year-old man who had head trauma 2 years ago was admitted two times during 3 months due to acute bacterial meningitis. Culture of CSF grew Streptococcus pneumoniae during the second admission. The temporal bone CT scan revealed the transverse fracture on the right temporal bone. CSF leakage through the fracture was corrected by the open cavity mastoidectomy with middle ear obliteration. After the operation further recurrence of bacterial meningitis has not occurred.

A Case of Recurrent Bacterial Meningitis and Mucocele After Cranial Trauma / 감염

Recurrent bacterial meningitis can be caused by acquired or congenital anatomic defects, infection, or alterations in immune mechanism. Intracranial anatomical defects possibly combined with trauma can be the major cause of recurrent bacterial meningitis. Mucocele is a chronic, expansile and cyst-like lesion of the paranasal sinuses, most frequently found in the frontal sinus containing sterile mucoid secretions. Secondary infection of a mucocele may create a pyocele. Although pathogenesis of a primary mucoceles remains uncertain, causatives factors of secondary mucoceles have been suggested to include chronic inflammation, trauma, allergy and obstructing tumors. We experienced a case of recurrent bacterial meningitis with frontal sinus mucocele, which might be secondary to cranial trauma.