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Review
. 2023 Aug 7;59(8):1428.
doi: 10.3390/medicina59081428.

Polymicrobial Bacterial Meningitis in a Patient with Chronic Suppurative Otitis Media: Case Report and Literature Review

Andrei Vâţă  1   2 , Erika Irimie-Băluţă  1 , Florin Manuel Roşu  2   3 , Ioana Maria Onofrei  1   2 , Isabela Ioana Loghin  1   2 , Mihaela Perţea  4 , Andrei Nicolae Avădanei  5 , Mihnea Miron  6 , Luminiţa Rădulescu  7 , Irina Eşanu  8 , Cătălina Mihaela Luca  1   2
Affiliations
Review

Polymicrobial Bacterial Meningitis in a Patient with Chronic Suppurative Otitis Media: Case Report and Literature Review

Andrei Vâţă et al. Medicina (Kaunas). .

Abstract

Polymicrobial meningitis is a rare entity in the adult population, especially in the antibiotic era. However, disorders such as chronic suppurative otitis media (CSOM) or even poor oral hygiene are considered risk factors for the development of such cerebral infection. We report a case of polymicrobial meningitis associated with oto-mastoiditis in a 64-year-old female patient known to have CSOM. The patient presented atypical symptoms for community-acquired meningitis, showing subacute evolution of headache, without fever or neck stiffness. The aerobe microorganisms Streptococcus anginosus and Corynebacterium spp., sensitive to beta-lactamines, and the anaerobe Prevotella spp., resistant to penicillin and metronidazole, were isolated from CSF specimens, while Proteus mirabilis and Enterococcus faecalis were identified from the ear drainage. The diversity of pathogens identified in our case led us to the hypothesis of two different sources of meningitis: otogenic and/or odontogenic. Favorable evolution was obtained after a multi-disciplinary approach, combining surgery and broad-spectrum antibiotics. In addition, we performed a literature review that highlights the low incidence of polymicrobial mixed aerobe-anaerobe meningitis.

Keywords: Corynebacterium; Prevotella; Streptococcus anginosus; chronic suppurative otitis media; odontogenic meningitis; polymicrobial meningitis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Case history timeline. CSF analysis, antibiotic therapy, and surgical procedures (ID—infectious diseases, ENT—ear–nose–throat clinic).
See this image and copyright information in PMC

References

    1. Li X., Du H., Song Z., Wang H., Long X. Polymicrobial Anaerobic Meningitis Detected by Next-Generation Sequencing: Case Report and Review of the Literature. Front. Med. 2022;9:840910. doi: 10.3389/fmed.2022.840910. - DOI - PMC - PubMed
    1. Al Qahtani H.M., Aljoqiman K.S., Arabi H., Al Shaalan H., Singh S. Fatal Meningitis in a 14-Month-Old with Currarino Triad. Case Rep. Radiol. 2016;2016:1346895. doi: 10.1155/2016/1346895. - DOI - PMC - PubMed
    1. Gutierrez M., Emmanuel P.J. Expanding Molecular Diagnostics for Central Nervous System Infections. Adv. Pediatr. 2018;65:209–227. doi: 10.1016/j.yapd.2018.04.005. - DOI - PubMed
    1. Sharma N., Jaiswal A.A., Banerjee P.K., Garg A.K. Complications of Chronic Suppurative Otitis Media and Their Management: A Single Institution 12 Years Experience. Indian J. Otolaryngol. Head Neck Surg. 2015;67:353–360. doi: 10.1007/s12070-015-0836-5. - DOI - PMC - PubMed
    1. Lee J.-J., Lien C.-Y., Chien C.-C., Huang C.-R., Tsai N.-W., Chang C.-C., Lu C.-H., Chang W.-N. Anaerobic bacterial meningitis in adults. J. Clin. Neurosci. 2018;50:45–50. doi: 10.1016/j.jocn.2018.01.014. - DOI - PubMed

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