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Atypical Streptococcal Meningitis with Fatal Cerebrovascular Complications: A Case Report

Gabriel D Pinilla-Monsalve1,2, Daniel F Torres-Cutiva1,3, Juan P Fernández-Cubillos1,2

  • 1Facultad de Ciencias de la Salud, Icesi University, Calle 18 No. 122-135, Cali 760032, Colombia.

Infectious Disease Reports
|November 25, 2020
PubMed

Insights

Atypical streptococcal meningitis, caused by species other than Streptococcus pneumoniae, can lead to severe cerebrovascular complications and death, even in healthy individuals. This case highlights the critical need for awareness of these rare but dangerous infections.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Microbiology

Background:

  • Bacterial meningitis is a significant public health concern, with *Streptococcus pneumoniae* being the most common pathogen.
  • Clinical presentations and outcomes of meningitis caused by non-*pneumoniae* streptococcal species are less understood.
  • Atypical streptococcal meningitis can present with severe neurological deficits and complications.

Observation:

  • A 23-year-old immunocompetent male presented with projectile vomiting, altered consciousness, cranial nerve palsy, and meningeal signs.
  • Neuroimaging revealed tonsillar herniation, empyema, sinus thrombosis, and multiple arterial infarcts.
  • Cerebrospinal fluid analysis indicated bacterial infection, with blood and abscess cultures positive for Streptococcus constellatus.

Findings:

  • Despite antibiotic treatment, the patient showed no clinical improvement and rapidly deteriorated.
  • Brainstem reflexes were abolished, leading to the declaration of brain death.
  • The case demonstrates a fatal outcome attributed to Streptococcus constellatus meningitis.

Implications:

  • Atypical streptococcal species, such as Streptococcus constellatus, can cause severe meningitis with lethal cerebrovascular complications.
  • Immunocompetent individuals are susceptible to severe outcomes from non-pneumoniae streptococcal meningitis.
  • This case underscores the need for heightened awareness and prompt management of meningitis caused by less common bacterial pathogens.
Keywords:
MeSHStreptococcus constellatusbacterial meningitiscranial sinus thrombosisstroke

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