{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:26:40Z","timestamp":1787758000527,"version":"build-2784847793"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>\n                    A\n                    <jats:sc>BSTRACT<\/jats:sc>\n                  <\/jats:title>\n                  <jats:p>Studies show nearly half to two-thirds of the children in India to be deficient in vitamin B12. Meningitis is a major disease in Indian children with studies attributing up to 22% of under-five deaths to meningitis and pneumonia. India is one of the countries with the highest mortality in absolute numbers due to meningitis. Usually, the diagnosis of each of these entities is straightforward. The presence of meningeal signs, papilledema, seizures, and altered sensorium often suggests meningitis. And vitamin B12 deficiency has a myriad of clinical presentations. At times, encephalopathy secondary to cobalamin deficiency may be confused with infection. Here, we present a case that presented with signs and symptoms suggestive of central nervous system infection but turned out to be cobalamin deficiency eventually. To our knowledge, this is the first presentation of cobalamin deficiency presented with features suggestive of meningitis.<\/jats:p>","DOI":"10.4103\/jfmpc.jfmpc_1428_21","type":"journal-article","created":{"date-parts":[[2022,6,30]],"date-time":"2022-06-30T10:17:00Z","timestamp":1656584220000},"page":"3318-3320","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Bacterial meningitis or cobalamin deficiency: A diagnostic conundrum"],"prefix":"10.4103","volume":"11","author":[{"given":"Anchal K.","family":"Tripathi","sequence":"first","affiliation":[{"name":"Department of Pediatrics, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keerti","family":"Swarnkar","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shikha","family":"Malik","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,6,30]]},"reference":[{"key":"B1-20240828","doi-asserted-by":"crossref","first-page":"4521","DOI":"10.3390\/nu5114521","article-title":"Cobalamin deficiency: Clinical picture and radiological findings","volume":"5","author":"Briani","year":"2013","journal-title":"Nutrients"},{"key":"B2-20240828","doi-asserted-by":"crossref","first-page":"4985","DOI":"10.4103\/jfmpc.jfmpc_712_20","article-title":"Vitamin B12 deficiency in children from Northern India: Time to reconsider nutritional handicaps","volume":"9","author":"Umasanker","year":"2020","journal-title":"J Fam Med Prim Care"},{"key":"B3-20240828","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1176\/appi.neuropsych.11020052","article-title":"The neuropsychiatry of vitamin B12 de\ufb01ciency in elderly patients","volume":"24","author":"Lachner","year":"2012","journal-title":"J Neuropsychiatry Clin Neurosci"},{"key":"B4-20240828","article-title":"Reversible vitamin B12 deficiency presenting with acute dementia, paraparesis, and normal hemoglobin","author":"Almoallim","year":"2016","journal-title":"Case Rep Neurol Med 2016"},{"key":"B5-20240828","doi-asserted-by":"crossref","first-page":"e229380","DOI":"10.1136\/bcr-2019-229380","article-title":"Encephalitis secondary to nitrous oxide and vitamin B12 deficiency","volume":"12","author":"Hughes","year":"2019","journal-title":"BMJ Case Rep"},{"key":"B6-20240828","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1186\/s12974-020-01763-y","article-title":"Vitamin B12 is neuroprotective in experimental pneumococcal meningitis through modulation of hippocampal DNA methylation","volume":"17","author":"de Queiroz","year":"2020","journal-title":"J Neuroinflammation"},{"key":"B7-20240828","doi-asserted-by":"crossref","first-page":"e0197198","DOI":"10.1371\/journal.pone.0197198","article-title":"Burden of bacterial meningitis in India: Preliminary data from a hospital based sentinel surveillance network","volume":"13","author":"Jayaraman","year":"2018","journal-title":"PLoS One"},{"key":"B8-20240828","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1002\/jgf2.268","article-title":"Sensitivity and specificity of meningeal signs in patients with meningitis","volume":"20","author":"Akaishi","year":"2019","journal-title":"J Gen Fam Med"},{"key":"B9-20240828","doi-asserted-by":"crossref","first-page":"71","DOI":"10.4103\/tjo.tjo_27_18","article-title":"Megaloblastic anemia and bilateral disc edema: An enigma\u2026Have we figured it out yet?","volume":"10","author":"Sethi","year":"2020","journal-title":"Taiwan J Ophthalmol"}],"container-title":["Journal of Family Medicine and Primary Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jfmpc.jfmpc_1428_21","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:01:52Z","timestamp":1787756512000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jfmpc.jfmpc_1428_21"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6]]},"references-count":9,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.4103\/jfmpc.jfmpc_1428_21","relation":{},"ISSN":["2249-4863","2278-7135"],"issn-type":[{"value":"2249-4863","type":"print"},{"value":"2278-7135","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6]]},"assertion":[{"value":"2021-07-17","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-12-16","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}