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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.

International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases
|April 16, 2018
PubMed

Insights

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.
Keywords:
Cerebral venous thrombosisMeningitisSplenectomyStreptococcus gallolyticusSubsp. pasteurianusWhole genome sequencing

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