Abstract Details

Title A rare case of Meningitis due to Streptococcus suis in an immunocompetent patient

Topic Infectious Disease

Presentation(s) P8 - Poster Session 8 (11:45 AM-12:45 PM)

Poster/Presentation
Number 4-007

Objective NA

Background
Introduction: Central nervous system (CNS) infection caused by Streptococcus
suis is extremely rare. Patients are infected by contact with live pigs or swine-
derived products. Symptoms include fever, headache, vomiting and
meningismus. It can be fatal if not treated immediately.

Design/Methods Case: In this report, we describe the case of a 52-year-old woman, from the
northern region of Brazil, without comorbidities, who suddenly developed fevers
of up to 39 degrees Celsius, holocephalic headache, nausea, and dizziness.
These symptoms progressively worsened over the course of a week,
progressing to tinnitus and hearing loss on the seventh day of symptoms. She
denied any contact with live pigs. She did not respond to over-the-counter
nonsteroidal anti-inflammatory drugs, prompting her to seek medical help.
Physical examination did not reveal skin or nail findings, but patient was in
distress and febrile. She was awake and oriented, with hypoacusis bilaterally
and unstable gait. No clear focality on neurological examination. She had
notable meningismus, with positive Kernig and Brudzinski signs, as well as
nuchal rigidity and pain. Notable laboratory evaluation for leukocytosis of
14.910/μL with 91% neutrophils, and C-reactive protein of 19.8mg/dL. Cranial
computed tomography showed confluent hypodensities of the posterior
periventricular white matter of the lateral ventricles. Lumbar puncture showed
160/μL white blood cells (32% polymorphonuclear, 68% monuclear), protein of
114mg/dL and glucose of 3mg/dL. Gram stain demonstrated gram-positive
cocci in a single chain, with cultures growing Streptococcus suis. The patient
was treated with ceftriaxone 2g intravenously daily for 10 days and
dexamethasone 10mg every 6 hours for 7 days, improved clinically
and was discharged 2 weeks after admission, without sequelae.

Results NA

Conclusions Discussion: Streptococcus suis CNS infection is rare and presents as typical
bacterial meningitis, even in patients without clear exposure to live pigs.
Patients respond well to prompt initiation of therapy with ceftriaxone and
glucocorticoids.

Authors/Disclosures
Roseliny M. Batista, Sr., MD PRESENTER	Mrs. Batista has nothing to disclose.
Carlos Correia, MD	No disclosure on file

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