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Case Reports
. 2020 May 13:21:e00779.
doi: 10.1016/j.idcr.2020.e00779. eCollection 2020.

Meningitis due to Streptococcus equi in a 73 year old woman with an osteodural defect

Zaghdoudi Aida  1 , Ammari Lamia  1 , Zayet Souheil  1 , Kilani Badreddine  1 , Bukta Monika  1 , Abdelmalek Rim  1 , Berriche Aida  1 , Harrabi Hajer  1 , Tiouiri Benaissa Hanen  1
Affiliations
Case Reports

Meningitis due to Streptococcus equi in a 73 year old woman with an osteodural defect

Zaghdoudi Aida et al. IDCases. .

Abstract

Meningitis caused by Streptococcus equi (SE) is a rare disease associated with high rates of complications. Commonly identified risk factors are regular horse contact and consumption of unpasteurized dairy products. When diagnosed promptly, this infection can be cured. We report the case of a 73 year old woman who presented to the hospital with a sudden holocranial headaches, fever, photophobia, sonophobia, vomiting and behavioural disorders. She lived in a rural area and regularly consumed unpasteurized milk products. She had a medical history of osteodural defect, chronic otitis, high blood pressure and pulmonary fibrosis. We suspected bacterial meningitis associated with an ear infection. A lumbar puncture was performed. Streptococcus equi zooepidemicus(SEZ) was discovered in the CSF's culture. Initially, the patient was treated with ceftriaxone. She had a tonic-clonic seizure 2days later. On the cerebral enhanced MRI, we found a right temporal pored cavity adjacent to a tegmen tympani bone breach. The patient received 15 days of antibiotic therapy with a good outcome. However, she was readmitted 24 h after being discharged for the same initial symptomatology. She received a total of 25 days of antibiotics and 4 days of corticoids with good results. Only a few cases of Streptococcus equi meningitis have been documented. We reported this case to insist on the importance of considering this diagnosis in patients with risk factors. We also point out that severe complications may occur despite the early initiation of adequate treatment.

Keywords: Meningitis; Osteodural defect; Streptococcus equi.

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Conflict of interest statement

The authors have no competing interests to declare.

Figures

Fig. 1
Fig. 1
Total filling of the right mastoid air cells.
Fig. 2
Fig. 2
The lysis of the tegmen tympani corresponding to a cholesteatoma chronic otitis media.
Fig. 3
Fig. 3
Subtotal filling of the midlle ear.
See this image and copyright information in PMC

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