Teenager Successfully Treated for Headache and Seizures Caused by Purulent Meningitis
At the age of 17, a young male patient was admitted to the hospital following a sudden seizure episode. The incident occurred in the evening, involving loss of consciousness, limb spasms, foaming at the mouth, and lasted for over ten minutes before gradually subsiding. After thorough examination, the patient was diagnosed with purulent meningitis, a type of bacterial meningitis. With timely medication and comprehensive treatment, symptoms such as headache improved significantly, and no further seizures were observed, ultimately leading to a full recovery.
Key Information
Patient: Male, 17 years oldCondition: Purulent MeningitisHospital: Jixi People's HospitalAdmission Date: April 2022Treatment: Intravenous antibiotics and supportive therapiesDuration: 21 days inpatient care followed by 1 month outpatient follow-upOutcome: Symptoms resolved, patient fully recovered
Initial Presentation
The patient was admitted after experiencing a seizure. Upon arrival, the episode had subsided, but he continued to suffer from severe headache, fatigue, and joint pain. Initially, a neurological disorder such as epilepsy was suspected. However, the patient's medical history revealed recent cold-like symptoms, including coughing, yellow phlegm, runny nose, and fever up to 38.0°C. These symptoms had persisted for a week, during which time only over-the-counter cold and fever medications were used. In the two to three days prior to the seizure, the patient had also experienced lethargy, worsening headache, and vomiting.
Upon physical examination, his temperature was recorded at 39.0°C, and lung auscultation revealed dry and wet rales. Neurological signs included neck stiffness and a positive Kernig's sign. Blood tests showed elevated white blood cell count (15.13×10^9/L), high neutrophil percentage (94.34%), increased C-reactive protein (186.76 mg/L), and elevated procalcitonin (13.89 ng/mL). Brain CT scans were normal, while lung CT revealed inflammatory changes in the lower left lobe. An EEG detected spike waves, confirming the diagnosis of meningitis-related seizure and headache.
Treatment Approach
Following consultation with the patient's family, they were reassured that prompt treatment could significantly improve the prognosis. A lumbar puncture confirmed the diagnosis, revealing elevated cerebrospinal fluid (CSF) pressure, increased protein levels (2394 mg/L), low glucose (0.03 mmol/L), and high white blood cell count (500×10^6/L).
The treatment plan included:
- Antibiotic Therapy: Intravenous ceftriaxone to target bacterial infection.
- Anti-inflammatory Support: Administration of Xuebijing injection for its antiviral and anti-inflammatory properties.
- Immune Modulation: Methylprednisolone to reduce brain inflammation and edema.
- Intracranial Pressure Management: Mannitol solution to alleviate brain swelling and reduce pressure.
- Seizure Control: Phenobarbital sodium administered intramuscularly to prevent further seizures.
Recovery and Follow-Up
After 21 days of intensive treatment and supportive care, the patient's condition improved dramatically. His fever subsided, seizures ceased, and neurological symptoms like headache and fatigue diminished. Throughout the recovery phase, the patient expressed concern about falling behind in school, particularly with upcoming college entrance exams. He was advised to prioritize rest, nutrition, and mental well-being to ensure a full recovery, which would ultimately support academic performance.
Outpatient follow-up was recommended for one month. The patient was advised to maintain a nutrient-rich diet, stay well-hydrated, and avoid overexertion. Proper nutrition and hydration are crucial during recovery, as they support immune function and reduce the risk of complications such as septic shock.
Clinical Insights
Purulent meningitis can affect individuals of any age, often following untreated infections such as colds, pneumonia, or gastroenteritis. In this case, the patient's initial cold symptoms progressed due to delayed treatment, allowing bacteria to invade the central nervous system and trigger seizures.
It is essential to seek medical attention promptly if symptoms like persistent fever, cough, diarrhea, or headaches develop. Early diagnosis and appropriate antibiotic therapy are critical for preventing long-term complications such as cognitive impairment or epilepsy. Timely intervention remains the most effective strategy for ensuring a favorable outcome in cases of bacterial meningitis.