AI Article Synopsis
- A 74-year-old woman experienced headaches, fever, and intermittent ear and nasal discharge, leading to the discovery of a cerebrospinal fluid (CSF) leak confirmed by Beta-2-Transferrin testing.
- High-resolution CT scans revealed a defect in her mastoid area and fluid accumulation, while an MRI indicated signs of ventriculitis, a serious brain condition.
- The patient successfully recovered with six weeks of IV antibiotics and underwent surgery to repair defects, emphasizing the need for high clinical suspicion and collaborative care in managing such rare cases.
Article Abstract
We present a case of a 74-year-old woman with headaches, pyrexia, and intermittent right-sided otorrhoea and rhinorrhoea. Her nasal discharge tested positive for Beta-2-Transferrin, confirming a cerebrospinal fluid (CSF) leak. High-resolution CT (HRCT) mastoids showed a defect in the right tegmen, and CSF within the middle ear and mastoid air cells. A gadolinium-enhanced MRI brain showed high signal in the occipital horns of the lateral ventricles with Diffusion-Weighted Imaging (DWI) and a low signal with DWI-Apparent Diffusion Coefficient (DWI-ADC), consistent with ventriculitis. She made an uneventful recovery after with six weeks of intravenous antibiotics. The patient had surgical repair of bony defects to prevent recurrence. This highlights a rare case of ventriculitis associated with a spontaneous CSF leak, with no existing set diagnostic criteria, and high mortality. High clinical suspicion aided by appropriate imaging, and a multidisciplinary approach to management is imperative.
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| http://dx.doi.org/10.1016/j.clinme.2024.100279 | DOI Listing |
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