Version 2: Escherichia coli K1 and Streptococcus pneumoniae meningitis in a young adult: a case report

Meningitis are severe infections of the membranes surrounding the brain and spinal cord, often caused by bacteria such as Streptococcus pneumoniae (S. pneumoniae) and Escherichia coli (E. coli). These infections can be particularly severe, especially in immunocompromised individuals. S. pneumoniae is a pathogen responsible for community-acquired meningitis, while E. coli K1, commonly observed in neonates and immunocompromised adults, can also cause severe infections. The clinical case described concerns a 26-year-old woman, immunocompromised due to systemic lupus erythematosus treated with hydroxychloroquine. She was admitted with a general decline in her condition, mental confusion, and dyspnea. Examination revealed bacterial meningitis, confirmed by a lumbar puncture showing abnormalities in the cerebrospinal fluid (CSF), including hyperproteinorachia and low glycorachia. Multiplex PCR enabled the simultaneous identification of E. coli K1 and S. pneumoniae, facilitating a rapid and precise diagnosis. Despite treatment with ceftriaxone, the patient passed away due to the severity of the infection. This case highlights the severity of meningitis in immunocompromised patients, whose impaired immune response can lead to rapid worsening of the infection. It also underscores the importance of multiplex PCR in the early diagnosis of complex co-infections, allowing for faster therapeutic adjustments and better management.