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Published on: July 1, 2018
[A case of Streptococcus suis meningitis in which the patient suffered sensorineural hearing loss and requring
Tomoki Ishimaru1, Kei Oiwa1, Sho Seo1
1Department of Neurology, Obihiro Kosei General Hospital.
Abstract:
A man in his 40s was transferred to our hospital due to headache, hearing loss, and altered consciousness, which developed several days after consuming a barbeque meal, including pork. Based on his clinical symptoms and various laboratory findings, he was diagnosed with bacterial meningitis caused by Streptococcus suis, and treatment was initiated with antibacterial agents and dexamethasone. After 3 weeks, his symptoms and laboratory results showed improvement, allowing for the discontinuation of the antibacterial therapy. However, a few days after stopping antibiotics, his symptoms and cerebrospinal fluid (CSF) findings worsened, prompting the resumption of antibacterial treatment. The therapy was ultimately terminated after 5 weeks, following confirmation of clinical and CSF improvement. Despite resolution of the meningitis symptoms, the patient was left with bilateral sensorineural hearing loss, predominantly affecting his right ear. Following systemic steroid administration and hyperbaric oxygen therapy, his left-sided hearing improved, but no improvement was observed in his right ear, and he continued to experience severe hearing loss.
Insights
A man developed Streptococcus suis meningitis after eating pork, requiring prolonged antibiotic treatment. While meningitis resolved, he suffered permanent bilateral hearing loss, with limited recovery in one ear despite steroid and hyperbaric oxygen therapy.
Area of Science:
- Infectious Diseases
- Neurology
- Otolaryngology
Background:
- Streptococcus suis is an emerging zoonotic pathogen causing meningitis.
- Bacterial meningitis can lead to significant neurological sequelae, including hearing loss.
Purpose of the Study:
- To report a case of Streptococcus suis meningitis with a focus on clinical presentation, treatment, and long-term complications.
- To highlight the potential for severe hearing loss as a sequela of Streptococcus suis meningitis.
Main Methods:
- Clinical case presentation and retrospective review of a patient diagnosed with Streptococcus suis meningitis.
- Analysis of clinical symptoms, laboratory findings, cerebrospinal fluid (CSF) analysis, and treatment response.
- Evaluation of hearing outcomes following treatment with antibacterial agents, dexamethasone, systemic steroids, and hyperbaric oxygen therapy.
Main Results:
- The patient presented with headache, hearing loss, and altered consciousness after consuming pork.
- Diagnosis of Streptococcus suis meningitis was confirmed, requiring a 5-week course of antibacterial therapy and dexamethasone.
- Despite initial improvement, relapse occurred after antibiotic discontinuation, necessitating retreatment.
- Permanent bilateral sensorineural hearing loss resulted, with partial recovery in the left ear but not the right.
Conclusions:
- Streptococcus suis meningitis is a serious infection that can lead to profound hearing loss.
- Prolonged antibiotic treatment may be necessary, and relapse is possible.
- Early intervention with steroids and hyperbaric oxygen may offer some benefit for hearing recovery, but complete resolution is not guaranteed.
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