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Streptococcus Oralis meningitis from right sphenoid Meningoencephalocele and cerebrospinal fluid leak

BACKGROUND: Streptococcus oralis belongs to the Streptococcus mitis group and is part of the normal flora of the nasal and oropharynx (Koneman et al., The Gram-positive cocci part II: streptococci, enterococci and the ‘Streptococcus-like’ bacteria. Color atlas and textbook of diagnostic microbiology...

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Autores principales: Patel, Kishan, Memon, Zain, Prince, Adam, Park, Connie, Sajan, Abin, Ilyas, Nazish
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6849159/
https://www.ncbi.nlm.nih.gov/pubmed/31711423
http://dx.doi.org/10.1186/s12879-019-4472-7
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author Patel, Kishan
Memon, Zain
Prince, Adam
Park, Connie
Sajan, Abin
Ilyas, Nazish
author_facet Patel, Kishan
Memon, Zain
Prince, Adam
Park, Connie
Sajan, Abin
Ilyas, Nazish
author_sort Patel, Kishan
collection PubMed
description BACKGROUND: Streptococcus oralis belongs to the Streptococcus mitis group and is part of the normal flora of the nasal and oropharynx (Koneman et al., The Gram-positive cocci part II: streptococci, enterococci and the ‘Streptococcus-like’ bacteria. Color atlas and textbook of diagnostic microbiology, 1997). Streptococcus oralis is implicated in meningitis in patients with decreased immune function or from surgical manipulation of the central nervous system. We report a unique case of meningitis by Streptococcus oralis in a 58-year-old patient with cerebral spinal fluid leak due to right sphenoid meningoencephalocele. CASE PRESENTATION: A 58-year-old female presented in the emergency department due to altered mental status, fevers, and nuchal rigidity. Blood cultures were positive for Streptococcus oralis. Magnetic resonance stereotactic imaging of head with intravenous gadolinium showed debris in lateral ventricle occipital horn and dural thickening/enhancement consistent with meningitis. There was also a right sphenoidal roof defect, and meningoencephalocele with cerebrospinal fluid leak as a result. The patient was treated with ceftriaxone and had endoscopic endonasal repair of defect. She had complete neurologic recovery 3 months later. CONCLUSIONS: Cerebrospinal fluid leak puts patients at increased risk for meningitis. Our case is unique in highlighting Streptococcus oralis as the organism implicated in meningitis due to cerebrospinal fluid leak.
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spelling pubmed-68491592019-11-15 Streptococcus Oralis meningitis from right sphenoid Meningoencephalocele and cerebrospinal fluid leak Patel, Kishan Memon, Zain Prince, Adam Park, Connie Sajan, Abin Ilyas, Nazish BMC Infect Dis Case Report BACKGROUND: Streptococcus oralis belongs to the Streptococcus mitis group and is part of the normal flora of the nasal and oropharynx (Koneman et al., The Gram-positive cocci part II: streptococci, enterococci and the ‘Streptococcus-like’ bacteria. Color atlas and textbook of diagnostic microbiology, 1997). Streptococcus oralis is implicated in meningitis in patients with decreased immune function or from surgical manipulation of the central nervous system. We report a unique case of meningitis by Streptococcus oralis in a 58-year-old patient with cerebral spinal fluid leak due to right sphenoid meningoencephalocele. CASE PRESENTATION: A 58-year-old female presented in the emergency department due to altered mental status, fevers, and nuchal rigidity. Blood cultures were positive for Streptococcus oralis. Magnetic resonance stereotactic imaging of head with intravenous gadolinium showed debris in lateral ventricle occipital horn and dural thickening/enhancement consistent with meningitis. There was also a right sphenoidal roof defect, and meningoencephalocele with cerebrospinal fluid leak as a result. The patient was treated with ceftriaxone and had endoscopic endonasal repair of defect. She had complete neurologic recovery 3 months later. CONCLUSIONS: Cerebrospinal fluid leak puts patients at increased risk for meningitis. Our case is unique in highlighting Streptococcus oralis as the organism implicated in meningitis due to cerebrospinal fluid leak. BioMed Central 2019-11-11 /pmc/articles/PMC6849159/ /pubmed/31711423 http://dx.doi.org/10.1186/s12879-019-4472-7 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Patel, Kishan
Memon, Zain
Prince, Adam
Park, Connie
Sajan, Abin
Ilyas, Nazish
Streptococcus Oralis meningitis from right sphenoid Meningoencephalocele and cerebrospinal fluid leak
title Streptococcus Oralis meningitis from right sphenoid Meningoencephalocele and cerebrospinal fluid leak
title_full Streptococcus Oralis meningitis from right sphenoid Meningoencephalocele and cerebrospinal fluid leak
title_fullStr Streptococcus Oralis meningitis from right sphenoid Meningoencephalocele and cerebrospinal fluid leak
title_full_unstemmed Streptococcus Oralis meningitis from right sphenoid Meningoencephalocele and cerebrospinal fluid leak
title_short Streptococcus Oralis meningitis from right sphenoid Meningoencephalocele and cerebrospinal fluid leak
title_sort streptococcus oralis meningitis from right sphenoid meningoencephalocele and cerebrospinal fluid leak
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6849159/
https://www.ncbi.nlm.nih.gov/pubmed/31711423
http://dx.doi.org/10.1186/s12879-019-4472-7
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