Case Report: Recurrent Bacterial Meningitis in a Child with Structural Defect of the Base of the Skull- A Rare Presentation

Recurrent bacterial meningitis (RBM) in children is unusual. It is usually associated with a predisposing factor, such as immunological deficiencies or anatomical defects. About 1.3% of children with bacterial meningitis had experienced at least one previous episode.  Anatomical defects are the most common risk factor for RBM. An accurate diagnosis of the underlying pathology is crucial for preventing the further recurrence of bacterial meningitis.
Case Report: We report a case of RBM in a 5-year-old female with a history of fever, projectile vomiting, neck stiffness, and seizures. There is a history of 3 admissions in the past, with the same history of clear nasal discharge, which usually precedes neck stiffness and seizures. A cranial CT scan showed a basal skull defect. She was co-managed with the ENT and neurosurgeon.
Conclusion: Recurrent bacterial meningitis, though infrequently encountered, poses a major diagnostic challenge. This case report contributes significant clinical insight into the presentation and management of a rare presentation in a low-resource tertiary healthcare setting. Its importance lies in highlighting diagnostic challenges and treatment approaches in the context of limited diagnostic infrastructure.