# Spinal Phlegmon Secondary to Neisseria meningitidis Meningitis With Possible Herpes Simplex Virus 1 Co-infection in an Immunocompetent Pediatric Patient

## TL;DR

A 5-year-old child with meningitis caused by Neisseria meningitidis and possibly HSV-1 developed a rare spinal infection, with a successful recovery after treatment.

## Contribution

First reported case of spinal phlegmon with meningococcal meningitis and HSV-1 co-infection in an immunocompetent child.

## Key findings

- Spinal phlegmon occurred in a child with meningococcal meningitis and HSV-1 co-infection.
- The patient showed no signs of immunodeficiency despite the rare polymicrobial infection.
- Treatment with prolonged antibiotics and antivirals led to a favorable outcome.

## Abstract

Spinal phlegmon has rarely been reported in meningococcemia. Simultaneous polymicrobial infection has been occasionally reported as the etiology of meningitis. The development of a spinal phlegmon and optic neuritis complicated meningitis in a five-year-old male who presented with clinical sepsis and meningitis. Neisseria meningitidis (N. meningitidis) and herpes simplex virus 1 (HSV-1) were demonstrated in the cerebrospinal fluid. Investigation of potential immunocompromise revealed no identified deficit. Protracted antibiotics and antiviral therapy were completed with a favorable clinical outcome. This is potentially the first reported case of spinal phlegmon associated with meningococcal meningitis in an immunocompetent pediatric patient. It occurred in the clinical context of what appeared to be a simultaneous infection by N. meningitidis and HSV-1.