Abstract

RAMIREZ-CALDERON, Fanny; SOTELO-JIMENEZ, Pedro  and  RODRIGUEZ-MALAVER, Carlos. Atypical presentation for bacterial meningitis in an elderly woman: report of a case. Acta méd. Peru [online]. 2019, vol.36, n.1, pp.62-67. ISSN 1728-5917.

Meningitis is an inflammatory process affecting leptomeninges, whose clinical manifestations are nonspecific both in the very young and the elderly. We present the case of a 70-year-old female patient who was admitted to emergency with 14-hour time of illness who presented with headache, vomiting, conscience impairment, and right hemiparesis. The patient was in a poor general condition, and the initial diagnosis was stroke. The brain CT scan showed no evidence of ischemic or hemorrhagic lesions. The patient worsened and developed fever, so a lumbar puncture was performed and empirical antibiotic treatment was started. Her condition got worse, and she died 36 hours after admission. Both the cerebrospinal fluid culture and the blood culture were positive for Streptococcus pneumoniae. We discuss the diagnosis, the atypical presentation, treatment and the need for the timely recognition of this condition.

Keywords : Meningitis, bacterial; Streptococcus pneumonia; Elderly.

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