Citation Information :
Krishnamurthy V, Narendra P, Goudar R, Gunda GV, Padyana M. A Rare Case of Primary Ventriculitis Secondary to Community-acquired Extended-spectrum β-lactamase Escherichia coli Meningitis. 2023; 2 (1):22-25.
Introduction: Gram negative bacterial meningitis is common among hospitalized patients with Traumatic brain injury, Neurosurgical patients and healthcare associated meningitis. Community acquired Gram negative bacillary meningitis is common in neonates but very uncommon in adults.
Case description: Hereby we present a case of community acquired extended-spectrum β-lactamase (ESBL) Escherichia coli (E. coli) meningitis with CSF and blood culture positivity by the same organism. The patient also developed primary bacterial ventriculitis on serial neuroimaging, which has been described in only seven adult cases so far.
Discussion: Incidence of community acquired E. coli meningitis is limited to few case reports and review of literature suggests that incidence is less than one case per year from 1946 to till date. The incidence of primary community-acquired ventriculitis is very uncommonly reported with no specific guidelines for management. Hence, the duration of total antimicrobial therapy was extended to a total duration of 6 weeks.
Conclusion: This case report addresses the emerging challenge of primary bacterial ventriculitis complicating community acquired meningitis due to an extremely uncommon ESBL E. coli pathogen and also addresses the need for development of formal recommendations, definition and guidelines for management of Primary Ventriculitis.
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