This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Aug 6, 2023; 11(22): 5344-5350 Published online Aug 6, 2023. doi: 10.12998/wjcc.v11.i22.5344
Persistent dysexecutive syndrome after pneumococcal meningitis complicated by recurrent ischemic strokes: A case report
Laura Abbruzzese, Giulia Martinelli, Giulia Salti, Benedetta Basagni, Alessio Damora, Cristiano Scarselli, Giulia Peppoloni, Aleksandra Podgorska, Giuliana Rosso, Marco Bacci, Alba Rosa Alfano, MAURO MANCUSO
Aleksandra Podgorska, Giuliana Rosso, Marco Bacci, MAURO MANCUSO, Physical and Rehabilitative Medicine Unit, NHS ASL-Tuscany South Est, Grosseto 58100, Italy
Alba Rosa Alfano, Department of Internal Medicine and Medical Specialties, UOC Geriatrics, Sapienza University of Rome, Rome 00185, Italy
Author contributions: Martinelli G, Salti G, Podgorska A, Rosso G, Bacci M, Scarselli C, Peppoloni G, contributed to manuscript data collection; Abbruzzese L and Basagni B writing and editing; MANCUSO M, Damora A, Alfano AR contributed to conceptualization and supervision; All authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient and her parents for the publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Received: April 24, 2023 Peer-review started: April 24, 2023 First decision: May 31, 2023 Revised: June 9, 2023 Accepted: July 17, 2023 Article in press: July 17, 2023 Published online: August 6, 2023 Processing time: 101 Days and 2.4 Hours
Abstract
BACKGROUND
Meningitis is a possible complication of pneumococcal infection concerning acute otitis media and sinusitis. It might compromise cognitive function, both for the infection itself and the vascular events that sometimes follow the acute phase.
CASE SUMMARY
Here we describe the case of a 32-year-old female patient admitted to the emergency room due to extensive pneumococcal meningitis as a consequence of sinus outbreak. She presented with extensive laminar ischemic damage in the acute phase, resulting in severe cognitive and behavioural impairment. Four years of follow-up, through neuropsychological assessments and neuroradiological investigations, demonstrated the presence of subsequent vascular events, 3 months and 2 years after onset.
CONCLUSION
The case is discussed in light of scientific knowledge of the long-term outcomes of this pathology in order to potentially improve diagnosis and promote better outcomes.
Core Tip: Meningitis is a possible complication of pneumococcal infection concerning acute otitis media and sinusitis. We describe the case of a 32-year-old female patient with extensive pneumococcal meningitis as a consequence of sinus outbreak. She presented with extensive laminar ischemic damage in the acute phase, resulting in severe cognitive and behavioural impairment. Four years of follow-up, through neuropsychological assessments and neuroradiological investigations, demonstrated the presence of subsequent vascular events, 3 months and 2 years after the onset. The global functional outcome was unfavorable.
