Abstract
We describe unusual delayed recurrent episodes of ischemic stroke in a patient with initial good recovery from pneumococcal meningitis due to progressive arterial stenosis for over 3 months. We postulate that any of the following may have been responsible for his condition: widespread cerebral vasculopathy due to the effects of purulent material bathing the base of the brain, an immune-mediated para-infectious condition, or a rebound effect of the primary inflammatory reaction that was initially suppressed by dexamethasone. This case demonstrates that progressive arterial stenosis can evolve months after bacterial meningitis and should be recognized as a potential vascular complication.
MeSH terms
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Acetamides / therapeutic use
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Brain Damage, Chronic / etiology
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Brain Ischemia / drug therapy
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Brain Ischemia / etiology*
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Ceftriaxone / therapeutic use
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Community-Acquired Infections / complications
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Community-Acquired Infections / drug therapy
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Constriction, Pathologic
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Dexamethasone / therapeutic use
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Disease Progression
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Drug Therapy, Combination
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Humans
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Linezolid
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Male
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Meningitis, Pneumococcal / complications*
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Meningitis, Pneumococcal / drug therapy
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Meropenem
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Middle Aged
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Oxazolidinones / therapeutic use
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Platelet Aggregation Inhibitors / therapeutic use
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Prednisolone / therapeutic use
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Recurrence
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Thienamycins / therapeutic use
Substances
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Acetamides
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Oxazolidinones
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Platelet Aggregation Inhibitors
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Thienamycins
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Ceftriaxone
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Dexamethasone
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Prednisolone
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Meropenem
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Linezolid