Case report of pyogenic meningitis after tooth extraction in an elderly diabetic patient

Introduction
Among elderly diabetic patients with comorbid conditions, the clinical characteristics of suppurative meningitis may not be typical, which is easy to cause misdiagnosis and delayed treatment.

Case presentation
In this report, we described the case of a 65-year-old elderly diabetic male who developed purulent meningitis after tooth extraction. The patient developed repeated infections (fever, headache and other symptoms) and was diagnosed with pyogenic meningitis by combining clinical manifestations and cerebrospinal fluid testing. The patient was treated with intracranial pressure reduction, nutritional support and anti-infection drugs, and recovered and was discharged after 15 days.

Conclusions
The atypical clinical presentation and insidious onset of the disease in this patient could easily lead to missed diagnosis and misdiagnosis. We emphasize that we should be vigilant with purulent meningitis and active treatment and prevention should be implemented in this subgroup of patients. During treatment, active anti-infection and nutritional support should be provided on the basis of blood glucose control.