A case of generalized lymphatic anomaly causing skull-base leakage and bacterial meningitis

Generalized lymphatic anomaly (GLA) is a multifocal lymphatic malformation that affects the skin, thoracic viscera, and bones. A 7-year-old boy presented with fever and disturbance of consciousness, and bacterial meningitis was diagnosed. Computed tomography and magnetic resonance imaging revealed middle skull-base leakage due to lymphatic malformation. Past history included facial palsy due to cystic tumors in the right petrous bone 4 years before onset of meningitis. At that time, pericardial effusion had been found and GLA had been diagnosed by pericardial biopsy. He achieved complete recovery under intensive care with antibiotics and mechanical ventilation. At the 3-year follow-up, the patient was healthy with no recurrence of meningitis. We should consider GLA among the differential diagnoses for osteolytic diseases in the pediatric population