{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T17:05:10Z","timestamp":1784307910385,"version":"3.55.0"},"reference-count":17,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Ischemic stroke is one of the rare but grave complications of meningitis with poor outcomes and long\u2010term sequelae, and the role of thrombolysis with infection\u2010related stroke remains uncertain. This case report documents a 52\u2010year\u2010old man presented with fever, headache, vomiting, and altered sensorium, and on examination he had neck rigidity. He was treated empirically for bacterial meningitis with antibiotics and dexamethasone, showing initial improvement. But on the 9th day of admission, he developed acute right upper motor neuron hemiparesis, dysarthria, and left\u2010sided facial palsy. Urgent computed tomography (CT) of the brain showed no hemorrhage, and he was thrombolysed with alteplase within 120\u2009min of symptom onset. Despite timely thrombolysis, there was no neurological recovery. Repeat brain CT confirmed acute ischemic stroke involving the left middle cerebral artery territory. Advanced imaging and endovascular thrombectomy were unavailable. He was managed conservatively with antiplatelets, statins, and physiotherapy, resulting in partial recovery on discharge. Stroke associated with meningitis presents both diagnostic and therapeutic challenges in resource\u2010limited settings. Thrombolysis in such cases is controversial, and outcomes may be poor due to inflammatory thrombus burden. This case underscores the need for further research and highlights the limitations of stroke management, especially in resource\u2010limited settings.<\/jats:p>","DOI":"10.1002\/ccr3.72875","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T11:25:50Z","timestamp":1780658750000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Case Report on Meningitis Complicated by Acute Ischemic Stroke and Failed Thrombolysis"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-9270-1439","authenticated-orcid":false,"given":"Sonam","family":"Dema","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Eastern Regional Referral Hospital  Mongar Bhutan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dechen","family":"Choden","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Eastern Regional Referral Hospital  Mongar Bhutan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonam","family":"Wangmo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Eastern Regional Referral Hospital  Mongar Bhutan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,5]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc10565"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2013.12.005"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.26618"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0000000000000547"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1159\/000544986"},{"key":"e_1_2_11_7_1","unstructured":"World Health Organization Meningitis. World Health Organization https:\/\/www.who.int\/health\u2010topics\/meningitis#tab=tab_1."},{"issue":"6","key":"e_1_2_11_8_1","article-title":"Management of Adults With Bacterial Meningitis in the Emergency Department","volume":"16","author":"Asemota J.","year":"2024","journal-title":"Cureus"},{"key":"e_1_2_11_9_1","volume-title":"SEARO Spearheads a Strategic Roadmap for \u201cDefeating Meningitis by 2030\u201d in the South East Asia Region","author":"World Health Organization","year":"2022"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccr3.9396"},{"key":"e_1_2_11_11_1","article-title":"Of 19,000 Bhutanese Screened for Stroke Risk 80% Found at High Risk","author":"Dema C.","year":"2025","journal-title":"Bhutanese"},{"key":"e_1_2_11_12_1","volume-title":"Annual Report 2024","author":"Eastern Regional Referral Hospital","year":"2025"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/1941874415588319"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/09727531251322546"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.4236\/wjns.2018.82015"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000475"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-020-01706-3"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.5603\/PJNNS.a2019.0032"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.72875","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccr3.72875","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.72875","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T16:22:36Z","timestamp":1784305356000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.72875"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":17,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1002\/ccr3.72875"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.72875","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"2025-09-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e72875"}}