Acute meningitis in adults caused by Streptococcus agalactiae is a rare entity. To our knowledge, there are only two cases associated with a central spinal fluid fistula published in the English literature from 1942 to the present. We report the third case. It was diagnosed in a 60-year-old woman with a twelve-year history of cerebrospinal rhinorrhea after a blunt head trauma. A CT scan of the base of the skull with administration of intrathecal contrast showed a disruption of the posterior and superior aspect of the sphenoid sinus with central spinal fluid leakage.