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Community-acquired Escherichia coli meningitis in adult

Shigeki Fujitani1, Toru Kamiya, Larry Kaufman

  • 1University of Hawaii, Internal Medicine Department, USA. shigekif@upmc.edu

Hawaii Medical Journal
|July 2, 2005
PubMed

Insights

Escherichia coli (E. coli) meningitis can present without typical nuchal rigidity. Early lumbar puncture and targeted antimicrobial therapy are crucial for managing this rare but severe infection.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Microbiology

Background:

  • Bacterial meningitis remains a significant cause of morbidity and mortality.
  • Escherichia coli (E. coli) is a rare cause of meningitis, particularly in non-neonatal populations.
  • Meningeal infections require prompt diagnosis and effective antimicrobial treatment.

Observation:

  • A case of E. coli meningitis was observed.
  • The patient presented with altered sensorium and fever, but notably lacked nuchal rigidity.
  • Cerebrospinal fluid (CSF) analysis was critical for diagnosis.

Findings:

  • Despite intensive care and appropriate treatment, the patient's CSF could not be sterilized.
  • The patient succumbed to the infection 17 days after admission.
  • This case highlights atypical presentations of E. coli meningitis.

Implications:

  • Clinicians should consider E. coli meningitis in patients with unexplained fever and altered mental status, even without nuchal rigidity.
  • Early lumbar puncture (LP) is essential for diagnosing rare meningeal pathogens.
  • Prompt and targeted antimicrobial therapy is vital for improving outcomes in bacterial meningitis.

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