Meningitis is a life-threatening infection often associated with high morbidity. Recurrent bacterial meningitis poses a clinical challenge, both clinically and diagnostically. To prevent further recurrences, the underlying causes of recurrent bacterial meningitis should be investigated intensively. Here, we aim to present a patient referred to our clinic with rhinorrhea and found to the Staphylococcus aureus meningitis related to a clival defect. The patient reported no history of trauma, surgery, or brain neoplasm, and the cerebrospinal fluid leakage was classified as spontaneous. The patient had two episodes of meningitis in the last 4 years, but etiologic data of the previous episodes were absent. A pneumococcal vaccine was administered following her second attack, suggesting a possible Staphylococcus aureus infection due to altered colonization in the sinuses. She was successfully treated with linezolid but refused surgery to correct the defect and was discharged without neurologic sequelae. Spontaneous cerebrospinal fluid leakage from the clivus which could provoke recurrent meningitis is a rare situation. In conjunction with appropriate rapid antibiotherapy for the prevention of recurrent meningitis, the removal of anatomical risk factors should be a principal aim. Effective surgical procedures prevent recurrences.

中文翻译：

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复发性脑膜炎发病机制中的分支缺陷：一例报道并文献复习

脑膜炎是威胁生命的感染，通常与高发病率相关。复发性细菌性脑膜炎在临床和诊断上均构成临床挑战。为防止进一步复发，应深入研究复发性细菌性脑膜炎的根本原因。在这里，我们的目的是向转诊至我们诊所的患者提出鼻漏，并发现其与分支缺损有关的金黄色葡萄球菌脑膜炎。该患者没有外伤，手术或脑部肿瘤的病史，并且脑脊液漏被归类为自发性。该患者在最近4年中有两次脑膜炎发作，但缺乏先前发作的病因学数据。她第二次发作后接种了肺炎球菌疫苗，提示可能由于鼻窦内定植改变而引起金黄色葡萄球菌感染。她已成功接受利奈唑胺治疗，但拒绝手术纠正该缺陷，并且无神经后遗症出院。自发性自发性脊柱漏出的脑脊液可能引起复发性脑膜炎，这种情况很少见。结合适当的快速抗生物疗法以预防复发性脑膜炎，消除解剖学危险因素应是主要目标。有效的手术程序可防止复发。结合适当的快速抗生物疗法以预防复发性脑膜炎，消除解剖学危险因素应是主要目标。有效的手术程序可防止复发。结合适当的快速抗生物疗法以预防复发性脑膜炎，消除解剖学危险因素应是主要目标。有效的手术程序可防止复发。