Cerebral vasculitis in a case of meningitis

Cerebral vasculitis is a serious complication of meningitis with Streptocccus pneumoniae. We report a 5 years old girl who was diagnosed to have pneumococcal meningitis with vasculitis on DWMRI within a week of onset of fever. She was given high dose of Methyl-prednisolone simultaneously with antibiotics and successfully treated without any neuro- sequelae. Although vasculitis has been documented to develop as a sequelae to bacterial meningitis usually in the second week, our patient had an early presentation. Treatment with high dose steroid along with antibiotics resulted in dramatic improvement with no neurodeficit. DWMRI is an important investigation to pick up early, evidence of vasculitis in a patient with meningitis who is showing neurological deteriorations despite of improvement in blood parameters.