Community-acquired Escherichia coli meningitis and spondylodiscitis in an adult patient with discoid lupus erythematosus

Abstract

Acute bacterial meningitis has a high impact on adult mortality worldwide. Community-acquired Escherichia coli meningitis (CA-ECM) is a rare and poorly described condition and the available knowledge is based on low evidence research, mainly from case reports. We describe a case of CA-ECM in Portugal in an adult patient with discoid lupus erythematosus under immunomodulatory therapy. A 73-year-old woman was admitted to the emergency department with fever and altered mental status over 48 h. Cerebrospinal fluid analysis showed 185 leukocytes/μL, including 85% neutrophils, hypoglycorrhachia (less than 5 mg/dL) and elevated protein of 423 mg/dL with positive culture for Escherichia coli . She was treated with ceftriaxone. Imaging studies also demonstrated spondylodiscitis and arthritis. She responded well to antimicrobial therapy and completed the treatment as an outpatient.

When a Stroke is not Just a Stroke: Escherichia coli Meningitis with Ventriculitis and Vasculitis: A Case Report

“…The presence of irregular debris on MRI is specific for pus, according to Fukui et al (2001) [12]. Recently, Vale et al (2019) [13] published a case of communityacquired E.coli meningitis in a patient with spondylodiscitis and discoid lupus erythematosus. The current case differs from that one in so far as the current patient did not have any significant co-morbidities.…”

Escherichia coli Spondylodiscitis: A Case Report and Literature Review

“…Escherichia coli is the normal flora of gastrointestinal tract in all humans (5,9). Some types of this mi- croorganism could cause a wide range of gastrointestinal and extra-gastrointestinal infections, most commonly gastroenteritis, urinary tract infections, bacteremia and neonatal meningitis (9). Infections such as skin and soft tissue induced by E. coli rarely occur and usually require a history of immunodeficiency, especially malignancy (10).…”