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Streptococcus gallolyticus (bovis): a rare presentation of meningitis in the ED

Joshua D Gray1, Christopher J Wilson1

  • 1Department of Emergency Medicine, Geisinger Medical Center, 100 N. Academy Ave, Danville, PA, 17822.

The American Journal of Emergency Medicine
|August 12, 2015
PubMed

Insights

Bacterial meningitis in the elderly is deadly, often caused by common bacteria. This case highlights Streptococcus gallolyticus as a rare cause of meningitis in an immunocompetent older woman.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Geriatrics

Background:

  • Bacterial meningitis is a severe condition in the elderly, with high mortality rates exceeding 20% despite antibiotic treatment.
  • Common causative agents include Streptococcus pneumoniae, Listeria monocytogenes, Escherichia coli, and Klebsiella pneumoniae.

Observation:

  • A case of meningitis caused by Streptococcus gallolyticus is presented in an elderly, immunocompetent female patient.
  • This presentation is unusual, as Streptococcus gallolyticus is rarely reported as a cause of meningitis, especially in immunocompetent individuals.

Findings:

  • Streptococcus gallolyticus can cause meningitis and altered mental status in elderly patients, even those who are immunocompetent.
  • This finding expands the spectrum of known pathogens responsible for bacterial meningitis in this demographic.

Implications:

  • Highlights the importance of considering less common pathogens in the differential diagnosis of meningitis in the elderly.
  • Suggests a need for further research into the prevalence and clinical characteristics of Streptococcus gallolyticus meningitis in immunocompetent elderly patients.

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