ESCHERICHIA COLI MENINGITIS IN AN IMMUNOCOMPROMISED ADULT PATIENT: A CASE REPORT

Imran Khan*, Andy Pan, Marlene Mansour, Bernadett Kovacs, Ariel Hendin, Caitlin Richler, Christine Landry, Kimberley Do, Laurent Montpetit, Sydney Morin, Deb Purkayastha, Melissa Varsava and Pierre Thabet

ABSTRACT

Bacterial meningitis remains one of the most severe central nervous system (CNS) infections, carrying significant morbidity and mortality, particularly in immunocompromised patients. In immunocompetent adults, the most common bacteria causing meningitis are Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitides.[1] In immunocompromised patients, there may be an increased incidence of pathogens such as Listeria monocytogenes, tuberculosis and gram-negative bacilli.[2] Immunocompromised states, such as those caused by malignancies and their treatments, including chemotherapy, radiation, and stem cell transplants, increase the risk of opportunistic and invasive infections.[3] Escherichia coli (E. coli), a common pathogen in urinary tract infections, gastrointestinal infections, and nosocomial infections, is less frequently implicated as a cause of bacterial meningitis, especially in adults. While E. coli is estimated to cause approximately 20% of neonatal meningitis cases, its occurrence in immunocompetent adults is exceedingly rare, with an estimated incidence of less than 0.1 cases per 100,000 individuals.[4] However, that risk increases in patients with compromised immune systems where E. coli can cause meningitis, bacteremia and end organ damage.[5,6,7]

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