Case 142


Female patient, 3-month-old, was admitted to the emergency service presenting hypoactivity, weak suction and fever for 4 days. Her medical history is unremarkable. At physical examination, the patient was irritable, normal pupillary reaction, ptosis and mydriasis at the left eye as well as a tense and bulging anterior fontanel. The CBC and lumbar puncture confirmed the clinical suspicion of meningitis by Neisseria meningitidis (meningococcus). Despite treatment with ceftriaxone the patient progressed with persistent fever, being requested computed tomography and magnetic resonance imaging of the brain.

Question: Based on clinical history and the images presented, what is the most possible complication presented by the patient?

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