Case Report

Chronic Granulomatous Meningitis With Multiple Cranial Nerve Lesions, Hydrocephalus, Stroke, Sinus Thrombosis, and Epilepsy

Authors: JOSEF FINSTERER, MD, PhD, ANDREA KLADOSEK, MD, IRIS-EVA NAGELMEIER, ALEXANDER BECHERER, MD, CHRISTIAN MATULA, MD, KARL-HEINZ STRADAL, MD, KUNRAD WOLF, MD, THOMAS CZECH, MD, GEROLD STANEK, MD

Abstract

ABSTRACT: &NA; Most frequently, chronic granulomatous meningitis (CGM) is caused by infectious agents. However, in some cases the cause of CGM remains undetermined. It is unclear whether antimicrobial agents, including antituberculous drugs, are helpful in such cases. We describe a 61‐year‐old man who had multiple cranial nerve lesions, epilepsy, sinus thrombosis, stroke, and hydrocephalus attributable to CGM. Repeated extensive search for a causative agent in the cerebrospinal fluid (CSF) and the meninges remained negative. Only a single culture of the sputum revealed growth of Mycobacterium tuberculosis, which prompted antituberculous therapy with isoniazid, rifampicin, and ethambutol. After 6 months of therapy, neurologic abnormalities were slightly improved. We conclude that antimicrobial/ antituberculous agents have only a minor short‐term effect in long‐lasting CGM of undetermined cause.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References