Neisseria meningitidis is a well-recognized cause of bacterial meningitis in infants and adolescents. Its intracranial suppurative complications, such as brain abscess, are exceedingly rare. Only a few published case reports describe this complication, most involving neonates. We report a case of a previously healthy 11-year-old male who presented with a one-day history of acute fever, abdominal pain, vomiting, and irritability. On investigation, cerebrospinal fluid analysis was consistent with bacterial meningitis; polymerase chain reaction detected Neisseria meningitidis, confirming meningococcal meningitis. While non-contrast computed tomography was normal, brain magnetic resonance imaging (MRI) demonstrated focal parenchymal changes within the left cerebellar hemisphere, consistent with a cerebellar abscess. Serial MRIs were obtained to follow up the patient’s recovery course. The patient demonstrated marked clinical and radiological improvement following a 21-day course of antimicrobial therapy. Early recognition and prompt neuroimaging are essential in patients with atypical or worsening neurological signs. To the best of our knowledge, this is the first documented case of meningococcal meningitis with cerebellar abscess in an 11-year-old child.
Al-Dahash et al. (Mon,) studied this question.