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Meningitis due to Aeromonas species: case report and review
1Department of Clinical Microbiology and Infectious Diseases, Hospital General Gregorio Marañón, Madrid, Spain.
Abstract:
In recent years, Aeromonas species has been reported to cause extraintestinal infections with a growing frequency. Meningitis due to Aeromonas species is, however, a rare entity. We report a case of aeromonas meningitis in a 54-year-old man with a history of chronic alcoholic liver disease who, after an episode of gastroenteritis, developed an acute clinical picture characteristic of meningitis with septic shock and ecthyma gangrenosum. Aeromonas veronii (biogroup sobria) was isolated from cultures of blood as well as from cultures of stool, peritoneal fluid, skin lesion, and CSF specimens (obtained by lumbar puncture). Our review of seven additional cases of aeromonas meningitis in the world literature revealed that this condition is generally secondary to metastatic dissemination from primary bacteremia. Aeromonas meningitis, which may or may not be preceded by gastroenteritis, presents clinically as bacterial meningitis, although the presence of skin lesions may increase suspicion of the diagnosis. Third-generation cephalosporins are probably the therapy of choice for patients with aeromonas meningitis.
Insights
Aeromonas meningitis is a rare but serious infection, often secondary to bloodstream infections. Early diagnosis and treatment with cephalosporins are crucial for managing this condition.
Area of Science:
- Infectious Diseases
- Microbiology
- Clinical Medicine
Background:
- Aeromonas species are increasingly recognized as causes of extraintestinal infections.
- Meningitis caused by Aeromonas species is an exceptionally rare clinical presentation.
Observation:
- A case of Aeromonas veronii meningitis in a 54-year-old male with alcoholic liver disease is presented.
- The patient developed meningitis with septic shock and ecthyma gangrenosum following gastroenteritis.
- Aeromonas veronii was identified in blood, stool, peritoneal fluid, skin lesions, and cerebrospinal fluid (CSF).
Findings:
- A literature review of eight cases indicates Aeromonas meningitis is typically a consequence of metastatic spread from bacteremia.
- Clinical presentation mimics bacterial meningitis, but skin lesions can suggest Aeromonas etiology.
- Gastroenteritis may precede meningitis but is not a universal finding.
Implications:
- This case highlights the importance of considering Aeromonas in severe infections, particularly in immunocompromised individuals.
- Prompt identification and appropriate antimicrobial therapy, likely third-generation cephalosporins, are essential for patient outcomes.
- Further research into the pathogenesis and optimal treatment strategies for Aeromonas meningitis is warranted.