Bacterial meningitis: a rare complication of an unrecognised nasal foreign body in a child

We present an interesting case of a 7-year-old child who developed severe bacterial meningitis requiring admission to paediatric ICU. Initial investigations failed to identify the reason for this otherwise healthy child to develop this life-threatening condition. The child recovered fully with no lo...

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Bibliographic Details
Published in:BMJ case reports 2017-01, Vol.2017, p.bcr2015209577
Main Authors: van der Veen, Jana, Thorne, Simon
Format: Article
Language:English
Subjects:
Antibiotics
Calcification
Child
Children & youth
Female
Foreign Bodies - complications
Foreign Bodies - diagnostic imaging
Humans
Learning from Errors
Maxillary Sinus - diagnostic imaging
Medical imaging
Meningitis
Meningitis, Pneumococcal - etiology
Nose
Nose - diagnostic imaging
Pathology
Rhinitis - diagnostic imaging
Rhinitis - etiology
Sinuses
Sinusitis - diagnostic imaging
Sinusitis - etiology
Streptococcus infections
Tomography, X-Ray Computed
United Kingdom
White
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Summary:We present an interesting case of a 7-year-old child who developed severe bacterial meningitis requiring admission to paediatric ICU. Initial investigations failed to identify the reason for this otherwise healthy child to develop this life-threatening condition. The child recovered fully with no long-term sequelae. Further on-going unilateral purulent rhinorrhoea lead to ENT referral. CT head from a previous admission showed mucosal thickening and fluid within paranasal sinuses. Reluctance to expose the child to further radiation meant that no formal scan of sinuses was organised and the child was diagnosed with chronic rhinosinusitis. Symptoms failed to improve despite the treatment. A subsequent CT scan of sinuses revealed a radiopaque foreign body in the nasal cavity. This is a rare presentation of a nasal foreign body causing bacterial meningitis. This case highlights the importance of comprehensive investigations to avoid delays in establishing a correct diagnosis and initiating the appropriate treatment.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2015-209577