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Lumbar puncture revealed turbid, blood-stained CSF with elevated protein and neutrophilic pleocytosis, but microbiological and autoimmune studies were negative. Neurological symptoms improved with conservative management (bed rest, hydration, analgesia), and follow-up imaging confirmed full resolution. Retrospective neuroradiological review reclassified findings as SIH. Conclusion:\u00a0SIH can mimic infectious meningoencephalitis both clinically and in CSF appearance. Recognition of preceding orthostatic headache and characteristic MRI features is essential to avoid unnecessary antimicrobial therapy and invasive diagnostic procedures.<\/jats:p>","DOI":"10.12890\/2025_005900","type":"journal-article","created":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T10:48:58Z","timestamp":1762512538000},"source":"Crossref","is-referenced-by-count":1,"title":["An unusual case of spontaneous intracranial hypotension presenting as meningoencephalitis"],"prefix":"10.12890","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7561-9014","authenticated-orcid":false,"given":"Mariana","family":"Dias","sequence":"first","affiliation":[{"name":"Servi\u00e7o de Medicina Interna, ULS Santa Maria, Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5386-6684","authenticated-orcid":false,"given":"Ana","family":"Mel\u00edcio","sequence":"first","affiliation":[{"name":"Servi\u00e7o de Medicina Interna, ULS Santa Maria, Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4908-2986","authenticated-orcid":false,"given":"H\u00e9lder Diogo","family":"Gon\u00e7alves","sequence":"first","affiliation":[{"name":"Servi\u00e7o de Medicina Interna, ULS Santa Maria, Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9164-7319","authenticated-orcid":false,"given":"Sara","family":"Vasconcelos Teixeira","sequence":"first","affiliation":[{"name":"Servi\u00e7o de Medicina Interna, ULS Santa Maria, Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1194-4483","authenticated-orcid":false,"given":"Jo\u00e3o","family":"Madeira Lopes","sequence":"first","affiliation":[{"name":"Servi\u00e7o de Medicina Interna, ULS Santa Maria, Lisbon, Portugal; Cl\u00ednica Universit\u00e1ria de Medicina II, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10397","published-online":{"date-parts":[[2025,11,7]]},"reference":[{"key":"10.12890\/2025_005900_ref1","doi-asserted-by":"crossref","unstructured":"Kranz PG, Gray L, Malinzak MD, Amrhein TJ. 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