Pneumocephalus is a condition characterized by the presence of air in the cranium and it is mainly caused by trauma or a neurosurgical procedure. Meningitis is an extremely rare cause of pneumocephalus. Only isolated case reports of meningitis leading to pneumocephalus is reported in literature. E coli meningitis leading to pneumocephalus is still rare. A rare case of spontaneous pneumocephalus in an infant, caused by E coli meningitis, with computed tomography finding and review of literature is presented here. 

Keywords: Pneumocephalus; E coli; Meningitis