TY - JOUR A2 - Bush, Larry M. AU - Hodges, Jacqueline AU - Matsumoto, Julie AU - Jaeger, Nicholas AU - Wispelwey, Brian PY - 2020 DA - 2020/10/20 TI - Gradenigo’s Syndrome and Bacterial Meningitis in a Patient with a Petrous Apex Cholesterol Granuloma SP - 8822053 VL - 2020 AB - Gradenigo’s syndrome (GS) classically involves a triad of ear pain due to acute or chronic otitis media (OM), facial or retro-orbital pain in the distribution of the trigeminal nerve, and an abducens nerve palsy. The simultaneous presentation of all three components has become less common in cases of GS reported in the literature, particularly in the era of antibiotics effective against typical organisms attributed to OM and petrous apicitis. In addition to infectious petrous apicitis arising directly from OM, more recent cases of GS are attributed to the compression of the same traversing cranial nerves in the presence of various expansile petrous apex (PA) lesions, both benign and malignant. We report a case of a 24-year-old male who presented initially with nausea, fever, photophobia, left-sided retro-orbital pain, and headache. He was diagnosed with bacterial meningitis by lumbar puncture and treated with empiric antibiotics, with CSF eventually revealing nontypeable 嗜血杆菌流感。在他的课程中几天，他开发了向左凝视的复视。脑成像揭示了一种膨胀，侵蚀PA胆固醇肉芽肿，具有相关的邻连续的多云和髓质化酶增强。患者随着抗生素的改善，最终接受了手术干预。这种在PA肉芽肿的环境中具有罕见脑膜炎的GS的非典型呈现，表明了早期识别该综合征的重要性，以及考虑预先存在的岩性病变患者的患者的增加的手术干预，这种危险风险较高GS的并发症。SN - 2090-6625 UR - https://doi.org/10.1155/2020/8822053 do - 10.1155 / 2020/8822053 jf - 案例报告Pb - Hindawi Kw - ER -