Cortical Laminar Necrosis as a Rare Complication of Streptococcus pneumoniae Meningitis: A Case Report

Cortical laminar necrosis (CLN) is a rare neurological complication that refers to ischemic injury of selective neuronal cortical layers. This condition often gets triggered by hypoxia, hypoglycemia, status epilepticus, immunosuppressive therapy, and rarely infection. This case report highlights the clinical presentation, diagnostic challenges, management, and outcomes of a patient who developed CLN due to bacterial meningitis. A 54-year-old woman with no significant medical history presented with high-grade fever, vomiting, and headache for two days. The clinical findings and cerebrospinal fluid (CSF) analysis indicated bacterial meningitis, leading to the initiation of empirical intravenous antibiotics. Despite initial improvement with antibiotics, the patient's condition worsened on day four, and she presented with increased headache and dizziness. An MRI performed on day four revealed CLN.