Intracranial mesenchymal tumor with EWSR1::CREM fusion represents a rare molecular subtype of FET::CREB fusion-positive neoplasms, provisionally recognized in the 2021 WHO Classification of Tumors of the Central Nervous System. These non-meningeal, primary intracranial tumors exhibit a broad histomorphologic spectrum and uncertain histogenesis; outcome data remain limited, yet their distinctive localization and unique histology warrant continued study. We analyzed 26 EWSR1::CREM fusion-positive patients, comprising 25 from the literature and one new patient-a 60-year-old woman with a history of breast carcinoma who presented with a right frontal mass. Histology demonstrated classic stellate/spindle cell morphology, abundant myxoid stroma, and positivity for EMA, CD99, desmin, and CD163. Following gross-total resection, she remains disease-free at 17 months, representing the second-oldest reported patient to date.

Infection with Capnocytophaga canimorsus is a rare, but potentially a life-threatening condition, which can cause sepsis, meningitis and endocarditis, as portrayed in this case report. Patients can typically report dog bites up to a week before symptoms of infection and medical assessment, but by then, their symptoms of local irritation may no longer be present. Thus, these patients might not mention this in their history. Awareness of Capnocytophaga infection among doctors is vital, as early recognition improves outcome.

Extrapulmonary tuberculosis represents a significant proportion of tuberculosis cases, and scrofuloderma is an uncommon cutaneous manifestation caused by contiguous spread from underlying structures, such as lymph nodes, bone, or joints. Its association with central nervous system involvement, particularly tuberculous meningitis, is rare and carries a high risk of morbidity and mortality if not promptly recognized. We report the case of a 69-year-old man who initially presented with painful, indurated supraclavicular and anterior thoracic skin lesions that progressed to ulceration with seropurulent discharge, clinically consistent with scrofuloderma. This was followed by intermittent low-grade fever and subsequent subacute neurological deterioration, including altered mental status, headache, somnolence, ataxia, and disorientation. On admission, he was febrile and found to have severe hyponatremia, a frequent metabolic complication of tuberculous meningitis. Cerebrospinal fluid analysis revealed lymphocytic pleocytosis, markedly low glucose, and elevated protein and lactate, consistent with tuberculous meningitis. Brain magnetic resonance imaging demonstrated right insular leptomeningeal enhancement and a subacute ischemic infarction in the right corona radiata, suggestive of tuberculous vasculitis. Histopathological examination and GeneXpert testing (Cepheid; Sunnyvale, CA, USA) of a skin biopsy confirmed infection with Mycobacterium tuberculosis (MTB), establishing the diagnosis in the absence of pulmonary involvement. Antituberculous therapy and adjunctive corticosteroids were promptly initiated, with favorable clinical evolution and progressive neurological improvement. This case highlights scrofuloderma as a potential initial manifestation of disseminated tuberculosis and underscores the importance of maintaining a high index of suspicion for tuberculous meningitis in patients presenting with chronic ulcerative skin lesions and neurological deterioration, even without a pulmonary disease, as early diagnosis and treatment are critical to improving outcomes.

Rapid prediction of meningeal deformation and puncture force is essential for surgical simulation and planning. This study proposes a reduced-order hybrid model combining a mass-spring-damper framework with a potential field method. The brain is simplified into meningeal, cerebrospinal fluid, and tissue layers to capture compression-induced deformation, interlayer interaction, and tissue resistance. Implemented in MATLAB, the model was validated using Abaqus simulations and brain-like phantom puncture experiments. At 5 mm puncture depth, it accurately predicted deformation and puncture force while running over two orders of magnitude faster than the conventional finite element method, enabling efficient simulation of puncture-induced tissue deformation.

Complicated infections of the middle ear and paranasal sinuses remain a relevant clinical challenge. Although acute otitis media and acute sinusitis are generally self-limiting, a small but clinically significant proportion of cases progress to severe local, orbital, or intracranial complications. These include acute mastoiditis, labyrinthitis, facial nerve palsy, orbital complications, frontal bone osteomyelitis, intracranial abscess, meningitis, and cerebral venous sinus thrombosis, all of which are associated with considerable morbidity and potential mortality. The current review provides an overview of the classification, clinical presentation, red flags, diagnostic workup, and microbiological spectrum of complicated disease courses as well as therapeutic strategies. The literature review is based on a selective search of the PubMed database, with particular consideration given to the current Association of the Scientific Medical Societies in Germany (AWMF) guidelines (as of 2025). Early recognition of warning signs and prompt interdisciplinary diagnostic and therapeutic management are crucial to prevent irreversible sequelae such as hearing loss, visual impairment, and permanent neurological deficits.

Meningitis is a condition characterized by inflammation of the meninges that can lead to severe neurological dysfunction and mortality. Epidural steroid injection is a common procedure performed for lumbar radiculopathy and the procedure has its risk and complications such as pneumocephalus, postural headache, meningitis, arachnoiditis, hematoma, abscess, and conus medullaris syndrome. Here, we discuss a case of complicated bacterial meningitis following epidural steroid injection.

Ischemic stroke is one of the rare but grave complications of meningitis with poor outcomes and long-term sequelae, and the role of thrombolysis with infection-related stroke remains uncertain. This case report documents a 52-year-old man presented with fever, headache, vomiting, and altered sensorium, and on examination he had neck rigidity. He was treated empirically for bacterial meningitis with antibiotics and dexamethasone, showing initial improvement. But on the 9th day of admission, he developed acute right upper motor neuron hemiparesis, dysarthria, and left-sided facial palsy. Urgent computed tomography (CT) of the brain showed no hemorrhage, and he was thrombolysed with alteplase within 120 min of symptom onset. Despite timely thrombolysis, there was no neurological recovery. Repeat brain CT confirmed acute ischemic stroke involving the left middle cerebral artery territory. Advanced imaging and endovascular thrombectomy were unavailable. He was managed conservatively with antiplatelets, statins, and physiotherapy, resulting in partial recovery on discharge. Stroke associated with meningitis presents both diagnostic and therapeutic challenges in resource-limited settings. Thrombolysis in such cases is controversial, and outcomes may be poor due to inflammatory thrombus burden. This case underscores the need for further research and highlights the limitations of stroke management, especially in resource-limited settings.

Syndromic molecular panels have improved the rapid etiological diagnosis of central nervous system (CNS) infections by enabling the simultaneous detection of multiple pathogens directly from cerebrospinal fluid (CSF). Their speed and standardization support early clinical decision-making, particularly in emergency and referral settings. However, the closed architecture of these panels limits pathogen coverage and does not allow antimicrobial susceptibility testing, potentially resulting in incomplete diagnostic assessment. A retrospective real-world evaluation of the BioFire® FilmArray® Meningitis/Encephalitis Panel (FA) was conducted over three years at a national reference center, comparing its performance with conventional culture.

Psoas abscess is a rare but serious infection most commonly caused by Staphylococcus aureus or enteric organisms. Streptococcus pyogenes is an exceptionally rare etiology, reported only in isolated cases. Invasive group A streptococcus (GAS) infections may follow gynecological procedures and can occur in otherwise healthy individuals. This report highlights an atypical presentation of GAS bacteremia with psoas myositis and developing abscess in an immunocompetent patient. A 21-year-old previously healthy woman presented with a 10-day history of worsening bilateral lower-extremity pain, fever, and inability to ambulate, beginning two weeks after a medication-induced abortion. On presentation, she was febrile and tachycardic, with significant leukocytosis (32,000/μL) and elevated inflammatory markers. Given her severe pain and limited mobility, initial concern for neurologic pathology prompted a lumbar puncture, which demonstrated cerebrospinal fluid pleocytosis. Empiric therapy for meningitis was initiated. Blood cultures later grew Streptococcus pyogenes, confirming bacteremia, and antibiotics were narrowed accordingly. Neurologic evaluation ultimately deemed meningitis unlikely, with findings consistent with a parameningeal inflammatory response. CT of the abdomen and pelvis demonstrated inflammation of the psoas and iliacus muscles, with interval imaging showing a small developing psoas abscess that was not amenable to drainage. No alternative infectious source was identified. The patient was managed with targeted intravenous antibiotics and supportive care. She demonstrated progressive clinical improvement, regained independent ambulation, and was discharged on oral antibiotics with outpatient follow-up. GAS-associated psoas abscess is exceedingly rare, particularly in immunocompetent patients without traditional risk factors. In this case, a recent medication-induced abortion likely served as the portal of entry through mucosal disruption and hematogenous spread. Diagnosis was complicated by an atypical presentation mimicking meningitis, including sterile cerebrospinal fluid pleocytosis. Recognizing that a parameningeal inflammatory response can be a secondary manifestation of a nearby infection is essential; this understanding encourages clinicians to look beyond the central nervous system and avoid delays in identifying retroperitoneal sources. Management depends on the abscess size and clinical stability. This report adds to evidence suggesting that small abscesses may be successfully managed with antibiotics alone. Additionally, the absence of localizing gynecologic symptoms may obscure the source of infection, necessitating a high index of suspicion. This report demonstrates that Streptococcus pyogenes can cause deep musculoskeletal infection in healthy individuals and may present with misleading neurologic manifestations. Early recognition, appropriate imaging, and targeted therapy are critical. Clinicians should consider a deep soft-tissue infection in post-gynecologic patients presenting with severe pain and systemic symptoms, even in the absence of classic risk factors.

Catheter-related bloodstream infections (CRBSIs) remain a serious complication in patients with hematologic malignancies, regardless of the causative microorganism, although Staphylococcus aureus remains an important pathogen because of its potential for rapid progression and metastatic complications. This report details the case of a 58-year-old man receiving immunochemotherapy for diffuse large B-cell lymphoma who developed fulminant sepsis 72 hours following the implantation of a totally implantable venous access port. The patient presented with high-grade fever, acute confusion, and local signs of port-site infection. Blood cultures confirmed methicillin-susceptible S. aureus bacteremia consistent with a catheter-related source. The diagnosis of secondary acute bacterial meningitis was confirmed by cerebrospinal fluid analysis and culture. Despite prompt initiation of empirical antimicrobial therapy, de-escalation to targeted anti-staphylococcal therapy, and catheter removal, the patient's condition rapidly deteriorated, and the patient died of refractory septic shock. This case highlights the aggressive progression and high mortality associated with S. aureus CRBSI complicated by hematogenous meningitis in immunocompromised patients and illustrates the importance of early recognition, prompt microbiological diagnosis, immediate source control, and vigilant clinical monitoring following catheter placement.