Congenital Nasal Lipomeningocele in an Infant: A Case of Cerebrospinal Fluid Rhinorrhea with Impending Meningitis

Congenital nasal lipomeningocele is a rare craniofacial anomaly caused by a skull base defect resulting in herniation of meninges and adipose tissue into the nasal cavity. It may present with nasal obstruction, cerebrospinal fluid (CSF) rhinorrhea, and an increased risk of meningitis, necessitating timely evaluation and intervention. We report the case of an 8.5-month-old female infant with a progressively enlarging congenital nasal mass and persistent CSF rhinorrhea since birth. Magnetic resonance imaging (MRI) confirmed a lipomeningocele in the left nasal cavity with a skull base defect. Due to signs of impending meningitis, lumbar puncture and intravenous antibiotics were promptly initiated. Surgical intervention was deferred to allow weight and hematologic optimization, thereby reducing perioperative risks such as recurrent infections and anesthesia-related complications. This case highlights the importance of early imaging, infection control, and multidisciplinary planning to prevent severe neurologic outcomes in infants with congenital nasal anomalies.