Unveiling a rare killer: Community-acquired Escherichia coli K1 meningitis in an adult patient

Escherichia coli (E. coli)-induced community-acquired meningitis in adults is exceedingly rare, with an average of only one annual case reported worldwide. The majority of E. coli meningitis cases in adults are associated with healthcare settings, typically following head injuries or neurosurgical interventions. Nonetheless, spontaneous E. coli meningitis in adults can arise in individuals with various comorbid conditions. This case report details the clinical presentation, diagnostic workup, management, and eventual outcome of a 45-year-old male with significant comorbidities who presented with severe respiratory distress, altered mental status, and generalized tonic-clonic seizure. Subsequently, multiplex PCR analysis of cerebrospinal fluid revealed E. coli K1. Despite aggressive management, including broadspectrum antibiotics, the patient deteriorated and succumbed to his illness. This report contributes to the understanding of E. coli K1 as a lethal pathogen in adult meningitis, emphasizing the need for vigilance in diagnosing and treating this condition.