Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2024 Jul 5;16(7):e63884.
doi: 10.7759/cureus.63884. eCollection 2024 Jul.

Unveiling the Veiled: Enteroviral Meningitis Mimicking Idiopathic Intracranial Hypertension

Sathvika A  1 , Nirmala D C  1 , Shiny Pj  2 , Sreevinishaa Ravichandran  1 , J S Kumar  1
Affiliations
Case Reports

Unveiling the Veiled: Enteroviral Meningitis Mimicking Idiopathic Intracranial Hypertension

Sathvika A et al. Cureus. .

Abstract

Meningitis is a significant health concern globally, with enterovirus (EV) being the most common cause of viral meningitis in adults. We discuss the case of a 57-year-old female patient with enteroviral meningitis manifesting as pseudotumor cerebri, posing significant clinical challenges. She presented with symptoms, signs, and radiological evidence suggesting idiopathic intracranial hypertension. The CSF analysis showed pleocytosis, which led to further investigations that unveiled a positive case of EV by real-time reverse transcription polymerase chain reaction analysis. This case highlights the fact that not all cases of raised intracranial pressure are detrimental or recalcitrant. It accentuates the need for thorough diagnostic evaluation and emphasizes the potential for favorable outcomes with conservative management.

Keywords: atypical presentation; central nervous system infections (cns); enteroviral meningitis; intracranial pressure; pseudotumor.

PubMed Disclaimer

Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Sagittal section contrast MRI of the brain illustrating the flattening of the pituitary gland (blue arrow) and a partially empty sella (yellow star)
Figure 2
Figure 2. Axial T2-weighted MRI of the brain at the level of the optic nerve, displaying hyperintense CSF around the optic nerve (green arrow) and bulging of the optic nerve papillae (red arrow), indicative of papilledema
See this image and copyright information in PMC

References

    1. Viral meningitis mimicking benign intracranial hypertension: a report of two cases. Kiefer L, Adam D, Mudugal D, Burnett MS. Interdiscip Neurosurg. 2020;20:100646.
    1. Enterovirus infections of the central nervous system. Rhoades RE, Tabor-Godwin JM, Tsueng G, Feuer R. Virology. 2011;411:288–305. - PMC - PubMed
    1. Kim D, Small JE. Neuroradiology. Amsterdam, The Netherlands: Elsevier; 2019. Idiopathic intracranial hypertension (pseudotumor cerebri) pp. 163–166.
    1. Bacterial meningitis: pathogenesis, pathophysiology, and progress. Quagliarello V, Scheld WM. N Engl J Med. 1992;327:864–872. - PubMed
    1. Intracranial pressure without brain tumor: diagnosis and treatment. Dandy WE. Ann Surg. 1937;106:492–513. - PMC - PubMed

Publication types

LinkOut - more resources