Pseudomonas aeruginosa meningitis complicated by cerebral vasculitis and ecthyma gangrenosum in a child: A case report and literature review.

Pseudomonas aeruginosa is a rare cause of community-acquired bacterial meningitis in children, typically associated with immunosuppression or neurosurgical interventions. We report a case of an 11-year-old boy with a family history suggestive of consanguinity who presented with fever, headache, and necrotic skin lesions consistent with ecthyma gangrenosum (EG). Cerebrospinal fluid (CSF) culture confirmed P. aeruginosa, and magnetic resonance imaging (MRI) revealed periventricular lesions indicative of cerebral vasculitis. Immunological evaluation suggested an underlying primary immunodeficiency. The patient recovered with antimicrobial therapy, surgical debridement, and intravenous immunoglobulin (IVIg), without corticosteroid use. This case highlights the rare triad of P. aeruginosa meningitis, cerebral vasculitis, and EG in a pediatric patient, emphasizing the need for early vascular imaging and immunodeficiency screening. A literature review compares similar cases and discusses diagnostic and therapeutic challenges.