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Case Reports in Emergency Medicine
Volume 2012, Article ID 193543, 2 pages
http://dx.doi.org/10.1155/2012/193543
Case Report

Isolated Torticollis May Present as an Atypical Presentation of Meningitis

1Emergency Department, New York Medical College, Metropolitan Hospital Center, New York, NY 10029, USA
2New York Medical College, Metropolitan Hospital Center, New York, NY 10029, USA

Received 27 April 2012; Accepted 9 July 2012

Academic Editors: Y. Inoue, K. Jani, and J.-N. Lin

Copyright © 2012 Roger Chirurgi and Samrina Kahlon. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Bacterial meningitis is a life-threatening medical emergency that requires urgent diagnosis and treatment. Diagnosis is infrequently missed if the patient presents with the classic symptoms of fever, headache, rash, nuchal rigidity, or Kernig or Brudzinski sign. However, it may be less obvious in neonates, elderly, or immunocompromised patients. Meningitis which presents as isolated torticollis, without any other signs or symptoms, is exceedingly rare. Objective. To identify an abnormal presentation of meningitis in an adult immunocompromised patient. Case Report. We present a case of an adult diabetic male who presented multiple times to the ED with complaint of isolated torticollis, who ultimately was diagnosed with bacterial meningitis. Conclusion. We propose that in the absence of sufficient explanation for acute painful torticollis in an immunocompromised adult patient, further evaluation, possibly including a lumbar puncture may be warranted.