Case of January 2024

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Clinical History:

53 years old man, who works as a cook, presented with acute onset of bilateral hearing loss, vomiting and fever for one day. On examination, he had positive Kernig’s sign and Brudzinski's sign. Plain CT Brain was unremarkable. White cell count was raised. Lumbar puncture was performed revealing raised leukocytes with positive gram stain - gram positive cocci in chains. He was treated empirically as bacterial meningitis but had persistent hearing impairment. CT Petrous Temporal Bones and MRI Internal Acoustic Meatus were performed.

CT Petrous Temporal Bones

Axial T1-Weighted Image of MRI Internal Acoustic Meatus

Axial T2-Weighted Image of MRI Internal Acoustic Meatus

Axial Contrast-Enhanced T1-Weighted Image of MRI Internal Acoustic Meatus