Polymicrobial anaerobic meningitis with ventriculitis involving Solobacterium moorei and Slackia exigua: A case...

Anaerobic bacteria are uncommon causes of bacterial meningitis. We report a rare case of polymicrobial anaerobic meningitis with ventriculitis involving Slackia exigua and Solobacterium moorei, both oral anaerobes. A 41-year-old woman presented with headache, vomiting, and impaired consciousness. Cerebrospinal fluid analysis was consistent with bacterial meningitis, and cultures yielded S. exigua and S. moorei, identified using matrix-assisted laser desorption ionization time-of-flight mass spectrometry, with S. exigua confirmed by 16S rRNA gene sequencing. Blood cultures showed polymicrobial bacteremia, including S. exigua, Streptococcus anginosus, and Desulfovibrio falkowii. The identification of D. falkowii was performed using 16S rRNA gene sequencing and corroborated by whole-genome sequencing. Untreated dental caries, periodontitis, and sinusitis were considered potential portals of entry. The patient responded favorably to continued antimicrobial therapy with ampicillin/sulbactam and metronidazole. This case highlights the clinical relevance of rare oral anaerobes in central nervous system infections. It underscores the polymicrobial nature of anaerobic meningitis and illustrates the potential value of combining conventional culture, matrix-assisted laser desorption ionization time-of-flight mass spectrometry, and molecular methods in identifying uncommon pathogens.