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Enterococcal meningitis caused by Enterococcus casseliflavus. First case report

Chiara Iaria1, Giovanna Stassi, Gaetano Bruno Costa

  • 1AILMI (Associazione Italiana per la Lotta contro le Malattie Infettive), Università di Messina, Italy. iariachiara@libero.it

BMC Infectious Diseases
|January 15, 2005
PubMed
Abstract

Insights

Enterococcus casseliflavus, typically causing other infections, was identified as a cause of meningitis in a rare case. This finding expands the known spectrum of Enterococcus meningitis pathogens.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Microbiology

Background:

  • Enterococcal meningitis is rare, primarily caused by Enterococcus faecalis and Enterococcus faecium, with high mortality.
  • Enterococcus casseliflavus is known to cause various human infections but has not previously been linked to meningitis.

Observation:

  • A 77-year-old female with rheumatoid arthritis on immunosuppressants presented with fever, stupor, and signs of meningitis.
  • Cerebrospinal fluid analysis revealed opalescence, low glucose, high protein, and elevated white blood cells with a predominance of neutrophils.
  • Cultures of cerebrospinal fluid identified Enterococcus casseliflavus as the causative agent.

Findings:

  • This case represents the first documented instance of meningitis caused by Enterococcus casseliflavus.
  • The patient received successful treatment with meropenem and ampicillin-sulbactam.

Implications:

  • Enterococcus casseliflavus should be considered an etiological agent of meningitis.
  • Increased awareness is needed for central nervous system infections caused by Enterococcus species, particularly those with intrinsic vancomycin resistance.

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