Bacterial meningitis is still a rare, serious, and depending on the cause in up to 30% of cases fatal disease. As part of the search for causes an ENT-focus search and, if necessary, a rapid surgical rehabilitation should be made.
We report a 45-year-old woman who was treated for bacterial meningitis alio loco. As pathogen Haemophilus influaenzae was detected. Following successful antibiotic therapy, a mass in the left sphenoid sinus was still detectable.
Due to the reimaging, the suspicion of a malignancy with destruction of the skull base in the area of the cavernous sinus and a resulting portal of entry for bacterial pathogens arose. Sampling revealed the diagnosis of low-grade neuroendocrine carcinoma. Due to the location a complete surgical removal was not possible. The patient received definitive radio-chemotherapy. So far, a complete remission is detectable.
Sinonasal carcinomas with neuroendocrine differentiation are very rare in 5% of all sinonasal malignancies. The prognosis depends on the degree of differentiation. There are no uniform treatment recommendations. In the literature, however, an advantage for the combined therapy of surgery and radiotherapy versus the single radiotherapy or surgery is described. The benefit of simultaneous chemotherapy is not proven in the studies. However, there are individual case reports with good results of a simultaneous radio-chemo.
