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Enterococcal meningitis: report of four cases and review

K B Stevenson1, E W Murray, F A Sarubbi

  • 1Department of Internal Medicine, James H. Quillen College of Medicine, East Tennessee State University, Johnson City 37614-0622.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|February 1, 1994
PubMed

Insights

Enterococcal meningitis is rare but serious, often affecting adults with underlying conditions and children with CNS issues. While mortality is 13%, optimal treatment strategies require further investigation.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Microbiology

Background:

  • Enterococci are common causes of non-CNS infections but rarely cause meningitis.
  • Understanding enterococcal meningitis is crucial due to its uncommon but significant nature.

Observation:

  • This study reviewed 32 cases of enterococcal meningitis, including 4 new cases and 28 from literature.
  • Adult patients often had comorbidities, immunosuppression, CNS trauma/surgery, or extra-CNS enterococcal infections.
  • Pediatric cases frequently involved underlying CNS abnormalities like neural tube defects or hydrocephalus.

Findings:

  • Clinical presentation and cerebrospinal fluid (CSF) findings were typical of acute bacterial meningitis.
  • The overall mortality rate for enterococcal meningitis was 13%.
  • No definitive difference in mortality was observed between monotherapy and combination therapy in this small cohort.

Implications:

  • Enterococcal meningitis requires prompt recognition and management, especially in at-risk populations.
  • Further research is needed to establish optimal therapeutic regimens, potentially favoring combination therapy with aminoglycosides.
  • This study contributes to the understanding of a rare but potentially severe infectious disease.

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