Question:medium
Which of the following agents is most commonly associated with recurrent meningitis due to CSF leaks?
Which of the following agents is most commonly associated with recurrent meningitis due to CSF leaks?
Show Hint
CSF leak plus recurrent meningitis equals pneumococcus, the dominant nasopharyngeal coloniser.
Updated On: Jun 24, 2026
- Meningococci
- Pneumococci
- Hemophilus influenzae
- E. coli
Show Solution
The Correct Option is B
Solution and Explanation
Picture the anatomy first. When there is a communication between the subarachnoid space and the air filled nose, sinuses, or middle ear, whether from a basilar skull fracture, surgery, or a congenital dural gap, the leaking cerebrospinal fluid betrays that a doorway has opened. Bacteria sitting in the upper airway can then march straight through that doorway again and again, which is why such patients suffer repeated bouts of meningitis.
The organism that exploits this route most often is $Streptococcus\ pneumoniae$. Pneumococcus is a heavy coloniser of the nasopharynx, so whenever a CSF leak provides access, it becomes the predominant cause of recurrent post traumatic or anatomical meningitis.
Now weigh the others. Neisseria meningitidis drives community outbreaks and sporadic disease but is not the signature organism of leak related recurrence. Haemophilus influenzae type b was historically a major paediatric meningitis pathogen, yet conjugate vaccines have curtailed it and it does not own this particular scenario. Escherichia coli belongs to the neonatal period, where it is picked up around delivery, not to recurrent meningitis through a CSF fistula.
Putting mechanism and microbiology together, the recurrent leak setting points squarely at the pneumococcus.
\[\boxed{\text{Pneumococci}}\]
The organism that exploits this route most often is $Streptococcus\ pneumoniae$. Pneumococcus is a heavy coloniser of the nasopharynx, so whenever a CSF leak provides access, it becomes the predominant cause of recurrent post traumatic or anatomical meningitis.
Now weigh the others. Neisseria meningitidis drives community outbreaks and sporadic disease but is not the signature organism of leak related recurrence. Haemophilus influenzae type b was historically a major paediatric meningitis pathogen, yet conjugate vaccines have curtailed it and it does not own this particular scenario. Escherichia coli belongs to the neonatal period, where it is picked up around delivery, not to recurrent meningitis through a CSF fistula.
Putting mechanism and microbiology together, the recurrent leak setting points squarely at the pneumococcus.
\[\boxed{\text{Pneumococci}}\]
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