Aspiration of Cerebrospinal Fluid Rhinorrhea as a Cause of Non-resolving Pneumonia

Intern Med. 2022 Jun 15;61(12):1877-1880. doi: 10.2169/internalmedicine.8596-21. Epub 2021 Nov 13.

Abstract

We herein report two cases of cerebrospinal fluid (CSF) rhinorrhea associated with lung infiltrates. One patient presented with symptomatic non-resolving pneumonia, while the other was asymptomatic. In both cases, the lung infiltrates completely resolved when CSF leakage had subsided. Pulmonary involvement in CSF rhinorrhea is under-recognized, and despite being the definitive treatment, surgery for CSF rhinorrhea is typically postponed due to the presence of lung infiltrates. However, meningitis is a serious complication due to a delay in surgical management. Physicians should be made aware that CSF rhinorrhea is a potential cause of intractable lung infiltrates.

Keywords: CSF rhinorrhea; aspiration pneumonia; non-resolving pneumonia.

MeSH terms

  • Cerebrospinal Fluid Leak / complications
  • Cerebrospinal Fluid Rhinorrhea* / diagnostic imaging
  • Cerebrospinal Fluid Rhinorrhea* / etiology
  • Cerebrospinal Fluid Rhinorrhea* / surgery
  • Humans
  • Meningitis* / complications
  • Meningitis* / diagnosis
  • Pneumonia* / complications