{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T12:12:03Z","timestamp":1785499923028,"version":"3.56.0"},"reference-count":8,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2017,9,28]]},"abstract":"<jats:p>Communicating hydrocephalus may complicate infantile bacterial meningitis, typically presenting with systemic features of infection. We report a rare case of \u2018subclinical meningoventriculitis\u2019 causing obstructive hydrocephalus and its challenging management. A healthy 10-week-old immunocompetent male patient presented with failure to thrive and vomiting, secondary to presumed gastro-oesophageal reflux. The child was neurologically alert, afebrile with normal inflammatory markers. Progressive macrocephaly prompted an MRI confirming triventricular hydrocephalus secondary to aqueductal stenosis. An endoscopic third ventriculostomy was performed however abandoned intraoperatively due to the unexpected finding of intraventricular purulent cerebrospinal fluid. A 6-week course of intravenous ceftriaxone was commenced for <jats:italic>Escherichia coli<\/jats:italic> meningoventriculitis. However, the child was readmitted 18 days postoperatively with acute hydrocephalus requiring a ventricular washout and staged ventriculoperitoneal shunt insertion at 4 weeks. Serial head circumference measurements are paramount in the assessment of a paediatric patient. In an immunocompetent child, a subclinical fibropurulent meningoventriculitis can result in several management challenges.<\/jats:p>","DOI":"10.1136\/bcr-2017-221849","type":"journal-article","created":{"date-parts":[[2017,10,12]],"date-time":"2017-10-12T01:25:12Z","timestamp":1507771512000},"page":"bcr-2017-221849","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Subclinical meningoventriculitis as a cause of obstructive hydrocephalus"],"prefix":"10.1136","volume":"2017","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2771-6434","authenticated-orcid":false,"given":"Ravindran","family":"Visagan","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, King\u2019s College Hospital NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent James","family":"Livermore","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, John Radcliffe Hospital, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominic","family":"Kelly","sequence":"additional","affiliation":[{"name":"Department of Paediatric Infectious Diseases and Immunology\/Oxford Vaccine Group, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shailendra","family":"Magdum","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, John Radcliffe Hospital, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,10,11]]},"reference":[{"key":"2025082804075600000_2017.oct11_1.bcr-2017-221849.1","unstructured":"Brunicardi C . 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