1. Rampant spread of infection in an afebrile immune-competent patient presenting with young-onset ischaemic stroke
- Author
-
Naval K. Vikram, Animesh Ray, Umang Arora, and Surabhi Vyas
- Subjects
Adult ,medicine.medical_specialty ,Infarction ,Unusual Association of Diseases/Symptoms ,Asymptomatic ,Meningitis, Bacterial ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Blood culture ,030212 general & internal medicine ,Stroke ,Ischemic Stroke ,medicine.diagnostic_test ,business.industry ,General Medicine ,medicine.disease ,Empyema ,Pons ,Surgery ,Klebsiella Infections ,Klebsiella pneumoniae ,Female ,medicine.symptom ,Orbital cellulitis ,business ,Meningitis ,Immunocompetence ,030217 neurology & neurosurgery - Abstract
A 27-year-old healthy woman developed spontaneous right-sided orbital cellulitis, followed by left hemiparesis and cranial nerve palsies. MRI revealed underlying basal exudates and vasculitic infarction involving the pons and cerebellar peduncles, following which a cerebrospinal fluid examination confirmed acute bacterial meningitis. Although the patient remained afebrile, imaging revealed asymptomatic septic foci in bilateral lungs, empyema and pyelonephritis. Blood culture grew drug-resistant Klebsiella pneumoniae. The case highlights the absence of fever in an immune-competent patient presenting with young-onset stroke secondary to meningitis.
- Published
- 2020