Pathology of Yersinia enterocolitica meningitis

Yersinia enterocolitica, a gram negative aerobic non-haemolytic bacillus, has been identified as a cause of meningitis only once before and the neuropathological features of Y. enterocolitica meningitis have not been reported in the literature. We describe the pathological features of a case of acute fatal meningitis caused by Y. enterocolitica, serotype 0:18, in a 47-year-old male alcoholic with cirrhosis. The organism presumably reached the meninges via the blood stream from the abdominal cavity. Intravascular fibrin thrombi, both recent and organising, were associated with multiple foci of necrosis in the brain. In spite of vigorous antibiotic therapy for three weeks the organism was cultured from the brain at autopsy. Among the various infections caused by Y. enterocolitica, meningitis appears to be the most difficult to eradicate.