Streptococcus agalactiae Meningoencephalitis Revealing Spondylodiscitis in a Diabetic Patient

Streptococcus agalactiae is a well-known pathogen responsible for neonatal and postpartum infections. An increase in the incidence of invasive Streptococcus agalactiae infections has been observed in non-pregnant adults. Involvement of the central nervous system in adults remains rare, and its association with spondylodiscitis is exceptional. We report the case of a 65-year-old diabetic patient who presented with acute meningoencephalitis. Microbiological analysis of cerebrospinal fluid and blood cultures identified Streptococcus agalactiae. Despite initial clinical improvement, the patient developed paraparesis and low back pain. Subsequent lumbar imaging revealed L3-L4-L5 spondylodiscitis with epidural and soft tissue abscess. The spinal involvement was presumably caused by the same pathogen. This case highlights the importance of considering the involvement of Streptococcus agalactiae in adult central nervous system infections, especially in the presence of comorbidities.