case_images: PMC11268772_01
case_images: The laboratory, imaging, and pathology examination results related to the Prevotella bivia meningitis. The green arrow indicates the strain seen under the microscope of the CSF specimen, and the red arrows indicate the location of the imaging changes. (A) Ultrasonography revealed 0.4cm anechoic area in the subarachnoid space (Day 0). (B) T2-fluid attenuated inversion recovery (T2-FLAIR), no subdural effusion (Day 1). (C) T2-FLAIR revealed enhancement and linear hyperintensity in the right middle cranial fossa, indicating mild meningitis (Day 1). (D) Diffusion-weighted imaging (DWI) showed diffusion limitation of the posterior horn of bilateral ventricles, suggesting ependymitis and empyema (Day 1). (E) Microscope examination showed a small number of gram-negative bacilli (Day 1). (F) T2-FLAIR displayed slightly higher signal intensity in the lower stripe of the left frontal cranial plate (Day 13).(G) T2-FLAIR exhibited enhancement in the subdural effusion and linear high signal intensity in the bilateral middle cranial fossa, suggesting increased severity of meningitis compared to previous findings (Day 13). (H) DWI showed the disappearance of high signal in the posterior horn of bilateral ventricles, indicating the improvement of empyema (Day 13). (I) Liver volume increased by 4.17cm (Day 6). (J) T2-FLAIR revealed decreased subdural effusion in the left forehead and at the midline of the right subcostal clavicle (Day 31). (K) Enhanced T2-FLAIR indicated improved meningitis compared to the earlier result (Day 31). (L) DWI showed normal findings in the posterior horn of bilateral ventricles (Day 31). (M) Bilateral sternocleidomastoid muscle scan indicated a thickness of approximately 0.60cm for the right muscle and 0.58cm for the left muscle (Day 27). (N) T2-FLAIR demonstrated significantly reduced left subdural effusion compared to the previous result, indicating basic absorption (Day 31), with further improvement on Day 69. (O) Enhanced T2-FLAIR indicated improved meningitis (Day 69). (P) No abnormalities were observed in the posterior horn of bilateral ventricles (Day 69).
case_images: IDR-17-3081-g0001.jpg
case_images: PMC11268772_02_IDR-17-3081-g0001.jpg
case_images: f0001
case_images: Although the cerebrospinal fluid analysis has not fully recovered, the ultrasonography and enhanced MRI revealed a further reduction in bilateral subdural effusion (Figure 1M-1P).
case_images: PMC11268772_02
case_images: The laboratory, imaging, and pathology examination results related to the Prevotella bivia meningitis. The green arrow indicates the strain seen under the microscope of the CSF specimen, and the red arrows indicate the location of the imaging changes. (A) Ultrasonography revealed 0.4cm anechoic area in the subarachnoid space (Day 0). (B) T2-fluid attenuated inversion recovery (T2-FLAIR), no subdural effusion (Day 1). (C) T2-FLAIR revealed enhancement and linear hyperintensity in the right middle cranial fossa, indicating mild meningitis (Day 1). (D) Diffusion-weighted imaging (DWI) showed diffusion limitation of the posterior horn of bilateral ventricles, suggesting ependymitis and empyema (Day 1). (E) Microscope examination showed a small number of gram-negative bacilli (Day 1). (F) T2-FLAIR displayed slightly higher signal intensity in the lower stripe of the left frontal cranial plate (Day 13).(G) T2-FLAIR exhibited enhancement in the subdural effusion and linear high signal intensity in the bilateral middle cranial fossa, suggesting increased severity of meningitis compared to previous findings (Day 13). (H) DWI showed the disappearance of high signal in the posterior horn of bilateral ventricles, indicating the improvement of empyema (Day 13). (I) Liver volume increased by 4.17cm (Day 6). (J) T2-FLAIR revealed decreased subdural effusion in the left forehead and at the midline of the right subcostal clavicle (Day 31). (K) Enhanced T2-FLAIR indicated improved meningitis compared to the earlier result (Day 31). (L) DWI showed normal findings in the posterior horn of bilateral ventricles (Day 31). (M) Bilateral sternocleidomastoid muscle scan indicated a thickness of approximately 0.60cm for the right muscle and 0.58cm for the left muscle (Day 27). (N) T2-FLAIR demonstrated significantly reduced left subdural effusion compared to the previous result, indicating basic absorption (Day 31), with further improvement on Day 69. (O) Enhanced T2-FLAIR indicated improved meningitis (Day 69). (P) No abnormalities were observed in the posterior horn of bilateral ventricles (Day 69).
case_images: IDR-17-3081-g0001.jpg
case_images: PMC11268772_02_IDR-17-3081-g0001.jpg
case_images: f0001
case_images: Although the cerebrospinal fluid analysis has not fully recovered, the ultrasonography and enhanced MRI revealed a further reduction in bilateral subdural effusion (Figure 1M-1P).