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Comamonas testosteroni meningitis in a homeless man

Long Jin1, Joshua A Perper, Stephen J Cina

  • 1Broward County Medical Examiner's Office, Fort Lauderdale, FL 33312, USA.

Journal of Forensic Sciences
|July 22, 2008
PubMed

Insights

This case report details the first fatal meningitis caused by Comamonas testosteroni, a bacterium typically found in soil and water. The infection occurred in a trauma patient with a severe facial bone fracture.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Microbiology

Background:

  • Comamonas testosteroni is a Gram-negative bacterium commonly found in environmental sources like soil and water.
  • Meningitis is a serious infection of the membranes surrounding the brain and spinal cord.

Observation:

  • A 54-year-old male with a history of alcoholism and homelessness sustained severe facial bone fractures after a car accident.
  • The patient developed cerebral and cerebellar infarcts, altered mental status, and was diagnosed with meningitis.
  • Autopsy revealed diffuse purulent meningitis, with cultures positive for Comamonas testosteroni.

Findings:

  • This is the first documented case of fatal meningitis attributed to Comamonas testosteroni.
  • The organism, typically non-pathogenic to humans, may have gained access to the central nervous system through the facial bone fractures.

Implications:

  • Highlights the potential for environmental bacteria to cause opportunistic infections in severely compromised hosts.
  • Suggests Comamonas testosteroni should be considered in the differential diagnosis of meningitis, especially in patients with relevant exposure or trauma.
  • Underscores the importance of considering unusual pathogens in severe infections following significant trauma.

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