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Mixed Streptococcus pneumoniae and Streptococcus pyogenes meningitis in an immunocompromised adult patient: a case

Clémence Demerle1, Vadim Ivanov2, Cédric Mercier2

  • 1Aix Marseille Université URMITE, UMR CNRS 7278, IRD 198, INSERM 1095, Faculté de Médecine, 27, Boulevard Jean Moulin, 13005, Marseille cedex 5, France.

Journal of Medical Case Reports
|November 30, 2015
PubMed
Abstract

Insights

This case report details a rare instance of mixed bacterial meningitis caused by Streptococcus pneumoniae and Streptococcus pyogenes in an immunocompromised patient. The patient successfully recovered without complications following antibiotic treatment.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Neurology

Background:

  • Community-acquired meningitis is typically monomicrobial, caused by either viruses or bacteria.
  • Mixed bacterial meningitis is exceptionally rare, posing diagnostic and therapeutic challenges.

Observation:

  • A 68-year-old immunocompromised male presented with otitis followed by meningitis.
  • Cerebrospinal fluid analysis revealed a mixed infection with Streptococcus pneumoniae and Streptococcus pyogenes.
  • Initial microscopic examination failed to distinguish between the two bacterial species.

Findings:

  • The patient received cefotaxime and dexamethasone for treatment.
  • The patient showed a positive response to the prescribed treatment.
  • No neurological sequelae were observed during the 4-month follow-up period.

Implications:

  • This case highlights the potential for polymicrobial meningitis in immunocompromised individuals with otorhinolaryngeal infections.
  • It underscores the importance of considering unusual pathogens in meningitis, even when initial diagnostics are inconclusive.
  • Barotrauma in immunocompromised patients with ear infections may increase the risk of severe, mixed bacterial meningitis.

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