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[Endocarditis and normal cell meningitis caused by group B streptococci]
1Herning Centralsygehus, medicinsk afdeling.
Ugeskrift for Laeger
|November 12, 1998
Summary
Bacterial meningitis typically shows high white blood cell counts in cerebrospinal fluid. This case highlights group B Streptococcus meningitis without pleocytosis, potentially delaying diagnosis and treatment.
Area of Science:
- Infectious Diseases
- Neurology
- Cardiology
Background:
- Bacterial meningitis classically presents with cerebrospinal fluid (CSF) pleocytosis, predominantly neutrophils.
- Neutrophilic CSF pleocytosis is a hallmark indicator for diagnosing bacterial meningitis.
- However, atypical presentations, including normocellular CSF, have been documented in the literature.
Observation:
- This report details a rare case of concomitant group B streptococcal (GBS) endocarditis and meningitis.
- The patient was a 40-year-old woman.
- Cerebrospinal fluid analysis revealed normocellularity, lacking the expected pleocytosis.
Findings:
- Group B Streptococcus meningitis can occur without the typical cerebrospinal fluid pleocytosis.
- Normocellular CSF in the presence of meningitis can be a misleading diagnostic finding.
- Concurrent endocarditis complicated the clinical picture.
Implications:
- Physicians must consider meningitis even with normal CSF cell counts, especially in high-risk patients.
- Delayed diagnosis due to atypical CSF findings can lead to adverse patient outcomes.
- This case underscores the importance of integrating clinical suspicion with diagnostic findings in complex infections.