BMJ Case Reports 2018; doi:10.1136/bcr-2017-222296
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Recurrent meningitis caused by idiopathic cerebrospinal fluid rhinorrhoea from the sphenoid sinus

Open Access
  1. Yasuhiro Tanaka3
  1. 1 Department of Otorhinolaryngology, Asahi General Hospital, Chiba, Japan
  2. 2 Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan
  3. 3 Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
  1. Correspondence to Dr Kazuhiro Omura, kazuhiro.omura{at}
  • Accepted 12 December 2017
  • Published 11 June 2018


A 41-year-old woman with 7 days of fever and headache had loss of consciousness 1 day prior to presentation. Despite the absence of trauma or other significant medical history, she had two episodes of meningitis in the previous 6 months. Physical examination showed no nuchal rigidity or abnormal findings on nasal endoscopy. Lumbar puncture showed a cerebrospinal fluid cell count of 750/μl. CT showed a bony defect of the posterior wall of the sphenoid sinus, which was filled with a soft tissue density. MRI showed fluid intensity in the same area (figure 1A, B). The diagnosis was recurrent meningitis due to possible idiopathic cerebrospinal fluid rhinorrhoea. …

Open Access

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