Abstract
Central nervous system immune reconstitution inflammatory syndrome (CNS-IRIS) describes clinical characteristics that may be observed in previously immunocompromised patients during rapid restoration of immunity function in the presence of a pathogen. There have been no reports about CNS-IRIS related to bacterial meningitis so far. Here, we report a 24-year-old pregnant female patient with bacterial meningitis. Her clinical and neuroradiological condition worsened after induced labor despite great effective anti-infective therapy. CNS-IRIS was considered. Corticosteroids were administered, and the patient gradually recovered. We present the first case of CNS-IRIS associated with bacterial meningitis.
Highlights
Infection of the central nervous system (CNS), usually presenting as meningitis or encephalitis, is linked to high mortality and morbidity rates throughout the world [1]
Weakness of the right limb continued, she was able to walk unaided. This case demonstrated the unusual characteristics of bacterial meningitis in a pregnant patient
CNS-IRIS induced by bacterial meningitis was diagnosed and treated with corticosteroids
Summary
Infection of the central nervous system (CNS), usually presenting as meningitis or encephalitis, is linked to high mortality and morbidity rates throughout the world [1]. Known as CNSimmune reconstitution inflammatory syndrome (CNS-IRIS), this paradoxical heightened immune response was initially identified in human immunodeficiency virus (HIV)-infected patients following anti-infection therapy and reversal of immune deficiency with antiretroviral therapy [2]. We describe an interesting case of CNS-IRIS in a pregnant patient with bacterial meningitis, who developed deteriorated neurologic symptoms as seen by brain imaging after induced labor and effective anti-infective therapy. After 20 days of antibiotic therapy, the patient underwent a successful medication abortion She developed weakness of the right limb, and fever again. The neurologic abnormalities gradually improved, and follow-up MRI showed marked improvement (Figure 2D) She was discharged from hospital three months after her admission. Weakness of the right limb continued, she was able to walk unaided
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
