Unusual Pyogenic Meningitis Masquerading as Leukodystrophy

Abstract

Meningitis is a frequent cause of morbidity and mortality in pediatric age-group with pyogenic cases outnumbering other etiologies especially in the Indian subcontinent. Though the diagnosis of meningitis is usually made on clinical and CSF examination yet imaging is often required to rule out focal lesions, hydrocephalus and other complications or when clinical examination is equivocal. Rarely, initial imaging may be normal or may suggest another diagnosis leading to clinicoradiological discordance making further detailed evaluation imperative. Hence, in this article, we present a rare case of pyogenic meningitis that mimicked leukodystrophy on initial imaging with unusual presentation on detailed imaging.