Xanthomatous Inflammatory Infiltrate Involving the Spleen: An Unusual Presentation of Erdheim-Chester Disease and Review of the Literature

Erdheim-Chester disease presenting as meningitis with hypoglycorrhachia: A case report

INTRODUCTION

Erdheim-Chester disease (ECD) commonly has neurologic manifestations but rarely presents with meningitis and hypoglycorrhachia. Here, were present a case of ECD with a clinical and laboratory presentation initially thought to be bacterial meningitis with sepsis.

METHODS

We report a case of a 79-year-old with history of enigmatic bone pain and peritoneal nodules who presented with meningitis. After failure to improve on antibiotic therapy other etiologies of hypoglycorrhachia including sarcoid, tuberculosis, and fungal and carcinomatous meningitis were considered. However, no definite diagnosis could be made based on radiologic, serologic, microbiologic, and molecular testing and the patient failed to improve on empiric therapy including antibiotics, antifungals, and tuberculosis and steroid therapy.

RESULTS

Ultimately, autopsy revealed a new diagnosis of ECD manifesting as meningitis, a rare presentation of a rare disease.

CONCLUSION

Although only reported in one other case to our knowledge, ECD can present with meningitis with hypoglycorrhachia.