Cargando…

Atypical Streptococcal Meningitis with Fatal Cerebrovascular Complications: A Case Report

Bacterial meningitis is an infectious pathology that remains a public health challenge. The most frequent etiological agent is Streptococcus pneumoniae, which is also associated with higher rates of mortality and sequels. However, less is known about the clinical presentation of atypical non-pneumon...

Descripción completa

Detalles Bibliográficos
Autores principales: Pinilla-Monsalve, Gabriel D., Torres-Cutiva, Daniel F., Fernández-Cubillos, Juan P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7768415/
https://www.ncbi.nlm.nih.gov/pubmed/33233326
http://dx.doi.org/10.3390/idr12030018
_version_ 1783629151265095680
author Pinilla-Monsalve, Gabriel D.
Torres-Cutiva, Daniel F.
Fernández-Cubillos, Juan P.
author_facet Pinilla-Monsalve, Gabriel D.
Torres-Cutiva, Daniel F.
Fernández-Cubillos, Juan P.
author_sort Pinilla-Monsalve, Gabriel D.
collection PubMed
description Bacterial meningitis is an infectious pathology that remains a public health challenge. The most frequent etiological agent is Streptococcus pneumoniae, which is also associated with higher rates of mortality and sequels. However, less is known about the clinical presentation of atypical non-pneumoniae streptococcal meningitis. Here, we studied a 23-year-old man with no medical background who presented with projectile vomiting, states of consciousness alteration, unilateral cranial nerve palsy, and meningeal signs. Neuroimaging showed tonsillar herniation, regions of empyema, right transverse and sigmoid sinuses thrombosis, and multiple arterial subcortical infarcts. Cerebrospinal fluid suggested bacterial infection; blood and abscess cultures were positive for Streptococcus constellatus. The patient received antibiotics with no clinical improvement. He deteriorated over the following days, the abolishment of brainstem reflexes was observed, and brain death was declared. Streptococcal meningitis produced by atypical species is a potential cause of lethal cerebrovascular complications, even in immunocompetent patients.
format Online
Article
Text
id pubmed-7768415
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-77684152020-12-29 Atypical Streptococcal Meningitis with Fatal Cerebrovascular Complications: A Case Report Pinilla-Monsalve, Gabriel D. Torres-Cutiva, Daniel F. Fernández-Cubillos, Juan P. Infect Dis Rep Case Report Bacterial meningitis is an infectious pathology that remains a public health challenge. The most frequent etiological agent is Streptococcus pneumoniae, which is also associated with higher rates of mortality and sequels. However, less is known about the clinical presentation of atypical non-pneumoniae streptococcal meningitis. Here, we studied a 23-year-old man with no medical background who presented with projectile vomiting, states of consciousness alteration, unilateral cranial nerve palsy, and meningeal signs. Neuroimaging showed tonsillar herniation, regions of empyema, right transverse and sigmoid sinuses thrombosis, and multiple arterial subcortical infarcts. Cerebrospinal fluid suggested bacterial infection; blood and abscess cultures were positive for Streptococcus constellatus. The patient received antibiotics with no clinical improvement. He deteriorated over the following days, the abolishment of brainstem reflexes was observed, and brain death was declared. Streptococcal meningitis produced by atypical species is a potential cause of lethal cerebrovascular complications, even in immunocompetent patients. MDPI 2020-11-21 /pmc/articles/PMC7768415/ /pubmed/33233326 http://dx.doi.org/10.3390/idr12030018 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Pinilla-Monsalve, Gabriel D.
Torres-Cutiva, Daniel F.
Fernández-Cubillos, Juan P.
Atypical Streptococcal Meningitis with Fatal Cerebrovascular Complications: A Case Report
title Atypical Streptococcal Meningitis with Fatal Cerebrovascular Complications: A Case Report
title_full Atypical Streptococcal Meningitis with Fatal Cerebrovascular Complications: A Case Report
title_fullStr Atypical Streptococcal Meningitis with Fatal Cerebrovascular Complications: A Case Report
title_full_unstemmed Atypical Streptococcal Meningitis with Fatal Cerebrovascular Complications: A Case Report
title_short Atypical Streptococcal Meningitis with Fatal Cerebrovascular Complications: A Case Report
title_sort atypical streptococcal meningitis with fatal cerebrovascular complications: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7768415/
https://www.ncbi.nlm.nih.gov/pubmed/33233326
http://dx.doi.org/10.3390/idr12030018
work_keys_str_mv AT pinillamonsalvegabrield atypicalstreptococcalmeningitiswithfatalcerebrovascularcomplicationsacasereport
AT torrescutivadanielf atypicalstreptococcalmeningitiswithfatalcerebrovascularcomplicationsacasereport
AT fernandezcubillosjuanp atypicalstreptococcalmeningitiswithfatalcerebrovascularcomplicationsacasereport