Gram-negative bacillary meningitis in an immunocompetent adult

BMJ Case Rep. 2023 Jan 10;16(1):e251850. doi: 10.1136/bcr-2022-251850.

Abstract

Escherichia coli is a rare cause of community-acquired meningitis comprising about 1% of adult cases. However, it is a common pathogen in neonatal meningitis and in nosocomial setting (especially after penetrating craniocerebral injury or subsequent to neurosurgical procedures). We report a middle-aged woman, who was admitted with features of acute meningitis and subsequent investigations revealed E. coli growth in cerebrospinal fluid culture. The case is distinctive as no additional predisposing risk factors associated with gram-negative bacillary meningitis (traumatic brain injury, neurosurgical procedures, malignancy, immunosuppressive therapy, HIV infection, chronic alcoholism and diabetes) were present. She was treated with intravenous antibiotics as per sensitivity reports and discharged in clinically stable condition, without any residual neurological deficit.

Keywords: General practice / family medicine; Infection (neurology); Meningitis; Neurology.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Escherichia coli
  • Female
  • HIV Infections* / complications
  • Humans
  • Infant, Newborn
  • Meningitis* / drug therapy
  • Meningitis, Bacterial* / complications
  • Meningitis, Bacterial* / diagnosis
  • Meningitis, Bacterial* / drug therapy
  • Middle Aged
  • Risk Factors

Substances

  • Anti-Bacterial Agents