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[Meningitis due to Streptococcus bovis type II]
A Ben-Ami1, G Gandelman, D Ergaz
1Dept. of Medicine B, Kaplan Hospital, Rehovot.
Abstract:
Meningitis due to Streptococcus bovis is rare. Only 14 cases having been reported in the English literature. All patients (including the patient described) had an underlying disease or were treated by pharmacological agents that predisposed the patient to the infection. Most were treated by monotherapy with penicillin G (or amoxicillin) and recovered. We describe a 74-year-old woman who had splenectomy as treatment for hairy cell leukemia 6 months before hospitalization for meningitis and sepsis by S. bovis type II. She was successfully treated with intravenous amoxicillin. There was neither evidence of endocarditis nor carcinoma of the colon. Although the association between S. bovis meningitis and endocarditis or carcinoma of the gastrointestinal tract is not well established, we recommend a full work-up for GI malignancy and endocarditis in every patient with S. bovis meningitis.
Insights
Streptococcus bovis meningitis is rare, often linked to underlying conditions. Prompt diagnosis and treatment, like amoxicillin, are crucial for recovery, with a recommendation for further investigation of potential GI malignancy or endocarditis.
Area of Science:
- Infectious Diseases
- Microbiology
- Neurology
Background:
- Meningitis caused by Streptococcus bovis (S. bovis) is an uncommon infection.
- Previous reports indicate a strong association between S. bovis meningitis and predisposing underlying conditions or immunosuppressive therapies.
Observation:
- A case of meningitis and sepsis caused by S. bovis type II in a 74-year-old woman, 6 months post-splenectomy for hairy cell leukemia, is presented.
- The patient had no evidence of endocarditis or gastrointestinal (GI) malignancy.
Findings:
- The patient was successfully treated with intravenous amoxicillin, highlighting the efficacy of antibiotic monotherapy.
- This case adds to the limited English literature on S. bovis meningitis, emphasizing its rarity and association with compromised health states.
Implications:
- The study recommends a comprehensive work-up for GI malignancy and endocarditis in all patients diagnosed with S. bovis meningitis, despite the association not being definitively established.
- Early recognition and appropriate management of S. bovis meningitis are essential, particularly in immunocompromised individuals or those with significant comorbidities.