Streptococcal meningitis with an unusual port of entry
I. Shadravan, J. Fishbein and L. J. Hebert
An 18-month-old boy developed meningitis due to group A beta-hemolytic
Streptococcus. Despite adequate antibiotic therapy with aqueous sodium
penicillin G and chloramphenicol for more than eight weeks, he showed
persistent abnormal spinal fluid findings, recurrent elevations of
temperature, irritability, and poor feeding. Further investigation revealed
a congenital dermal sinus of the nose, with an entry into the anterior
fossa that made a small opening intradurally at the level of the cribiform
plate. Surgical removal of the entire sinus tract resulted in a speedy and
complete recovery.
