{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T06:22:27Z","timestamp":1793859747620,"version":"4.6.1"},"reference-count":15,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,1,26]]},"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:p>A previously healthy young man presented to hospital with severe traumatic brain injury following a motor vehicle collision. Within 24 hours of admission, and despite antibiotic coverage, he developed a fever. On the second day, the source of infection was discovered to be purulent pneumococcal meningitis. At 48 hours post-accident, he developed brain-stem death without evidence of raised intracranial pressure or trans-tentorial herniation. Initial CT scans of the head were essentially normal, but early repeat scans revealed evidence of pneumocephalus and possible frontal bone fracture. Current recommendations do not make room for targeted antibiotic prophylaxis in traumatic brain injury patients with traumatic skull fracture. We argue that our case demonstrates the need for aggressive targeted antibiotic prophylaxis in the presence of certain features such as frontal or sphenoid bone fracture and pneumocephalus.<\/jats:p>","DOI":"10.1136\/bcr-2019-232692","type":"journal-article","created":{"date-parts":[[2020,2,18]],"date-time":"2020-02-18T03:45:16Z","timestamp":1581997516000},"page":"e232692","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Rapidly fatal pneumococcal meningitis following non-penetrating traumatic brain injury"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1519-523X","authenticated-orcid":false,"given":"Gustav","family":"Strandvik","sequence":"first","affiliation":[{"name":"Trauma Department, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Shaaban","sequence":"additional","affiliation":[{"name":"Neurosurgery, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdelrahman Rawhi Mahmoud","family":"Alsaleh","sequence":"additional","affiliation":[{"name":"Trauma Department, Hamad Medical Corporation, Doha, Qatar"},{"name":"ENT Department, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Mohsin","family":"Khan","sequence":"additional","affiliation":[{"name":"Neurosurgery, Hamad Medical Corporation, Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,2,17]]},"reference":[{"key":"2025082707564241000_13.2.e232692.1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1993.01420230088014"},{"key":"2025082707564241000_13.2.e232692.2","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1097\/TA.0000000000001627","article-title":"Early fever after trauma: does it matter?","volume":"84","author":"Hinson","year":"2018","journal-title":"J Trauma Acute Care Surg"},{"key":"2025082707564241000_13.2.e232692.3","doi-asserted-by":"crossref","first-page":"E50","DOI":"10.1097\/HTR.0000000000000271","article-title":"Early fever as a predictor of paroxysmal sympathetic hyperactivity in traumatic brain injury","volume":"32","author":"Hinson","year":"2017","journal-title":"J Head Trauma Rehabil"},{"key":"2025082707564241000_13.2.e232692.4","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00008-11"},{"key":"2025082707564241000_13.2.e232692.5","first-page":"CD004884","article-title":"Antibiotic prophylaxis for preventing meningitis in patients with basilar skull fractures","volume":"4","author":"Ratilal","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"2025082707564241000_13.2.e232692.6","doi-asserted-by":"crossref","first-page":"757","DOI":"10.3171\/jns.2004.101.5.0757","article-title":"Prophylactic administration of ceftriaxone for the prevention of meningitis after traumatic pneumocephalus: results of a clinical trial","volume":"101","author":"Eftekhar","year":"2004","journal-title":"J Neurosurg"},{"key":"2025082707564241000_13.2.e232692.7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2019\/7876494","article-title":"Pneumocephalus and meningitis as complications of mastoiditis","volume":"2019","author":"Barry","year":"2019","journal-title":"Case Rep Radiol"},{"key":"2025082707564241000_13.2.e232692.8","doi-asserted-by":"crossref","first-page":"1129","DOI":"10.2169\/internalmedicine.51.6861","article-title":"An adult case of pneumocephalus and pneumococcal meningitis associated with the sphenoid sinusitis","volume":"51","author":"Ohe","year":"2012","journal-title":"Intern. Med."},{"key":"2025082707564241000_13.2.e232692.9","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1960.03020340036010"},{"key":"2025082707564241000_13.2.e232692.10","doi-asserted-by":"crossref","unstructured":"Greenberg MS . Handbook of neurosurgery. 8th edn. New York: Thieme, 2016: 1661.","DOI":"10.1055\/b-006-149702"},{"key":"2025082707564241000_13.2.e232692.11","doi-asserted-by":"publisher","DOI":"10.1016\/0735-6757(83)90109-2"},{"key":"2025082707564241000_13.2.e232692.12","doi-asserted-by":"crossref","first-page":"245","DOI":"10.23736\/S0390-5616.16.03287-X","article-title":"Vaccination as primary prevention? the effect of anti-pneumococcal vaccination on the outcome of patients suffering traumatic skull base fractures","volume":"61","author":"Cohen-Inbar","year":"2017","journal-title":"J Neurosurg Sci"},{"key":"2025082707564241000_13.2.e232692.13","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1016\/j.vaccine.2016.12.065","article-title":"Pneumococcal polysaccharide vaccination administered early after neurotrauma or neurosurgery","volume":"35","author":"Hedberg","year":"2017","journal-title":"Vaccine"},{"key":"2025082707564241000_13.2.e232692.14","doi-asserted-by":"crossref","first-page":"1552","DOI":"10.1111\/jphp.12282","article-title":"Pharmacokinetics of ceftriaxone in plasma and bone of patients undergoing hip or knee surgery","volume":"66","author":"Gergs","year":"2014","journal-title":"J Pharm Pharmacol"},{"key":"2025082707564241000_13.2.e232692.15","first-page":"181","article-title":"Brain abscess caused by Streptococcus pneumoniae with acute onset and rapid progressive symptoms","volume":"12","author":"Gdynia","year":"2007","journal-title":"Eur J Med Res"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-232692","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T14:56:52Z","timestamp":1756306612000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-232692"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2]]},"references-count":15,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2020,2,17]]},"published-print":{"date-parts":[[2020,2]]}},"alternative-id":["10.1136\/bcr-2019-232692"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-232692","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,2]]}}}