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Streptococcus gallolyticus subsp. pasteurianus meningitis complicated by venous sinus thrombosis: A case report
Martin Wardle1, Andre Mu2, Steven Y C Tong3
1Victorian Infectious Diseases Service, The Royal Melbourne Hospital, Victoria, Australia.
Summary
This case report details a rare instance of Streptococcus gallolyticus subsp. pasteurianus meningitis in a splenectomized patient, complicated by cerebral venous thrombosis. Whole genome sequencing aided in identifying the subspecies and highlighted splenectomy as a potential risk factor.
Area of Science:
- Infectious Diseases
- Neurology
- Microbiology
Background:
- Streptococcus gallolyticus subsp. pasteurianus is a recognized cause of meningitis.
- Splenectomy is a known risk factor for certain bacterial infections.
- Cerebral venous thrombosis (CVT) is a serious neurological complication.
Observation:
- A splenectomized patient presented with meningitis caused by Streptococcus gallolyticus subsp. pasteurianus.
- The patient subsequently developed symptoms consistent with cerebral venous thrombosis.
- Cerebral imaging confirmed venous thrombosis in the right frontal cortical veins and left sigmoid sinus.
Findings:
- This is the first reported case of Streptococcus gallolyticus subsp. pasteurianus meningitis in a splenectomized individual.
- Cerebral venous thrombosis is identified as a novel complication of Streptococcus gallolyticus subsp. pasteurianus infection.
- Short-read whole genome sequencing was crucial for accurate subspecies identification.
Implications:
- Splenectomy should be considered a potential risk factor for Streptococcus gallolyticus subsp. pasteurianus meningitis.
- Clinicians should be vigilant for cerebral venous thrombosis in patients with Streptococcus gallolyticus subsp. pasteurianus meningitis, especially those who are asplenic.
- Accurate identification of bacterial subspecies using genomic methods can inform clinical management and risk assessment.
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