Article révisé par les pairs
Résumé : Background Meningitis caused by Escherichia coli K1 occurs only in specific cases: in neonates or in adults following trauma or in a nosocomial context resulting from procedures that create a direct entry point, such as neurosurgical procedures. Community-acquired cases in adults are rare, and those secondary to septic arthritis are even rarer. In this article, an exceptionally uncommon case of community-acquired meningitis due to Escherichia coli O25:K1:H4 (sequence type 95) with concomitant septic arthritis at the L4/L5 level is described, emphasizing the diagnostic process, which was aided by detailed microbiological documentation. Case presentation A 73-year-old man with a history of hypertension, alcohol use, and atrial fibrillation presented with acute lower back pain, confusion, persistent vomiting, headache, lethargy, and low-grade fever (37.9 °C). He also demonstrated a positive Lasegue's sign and had elevated inflammatory markers without an obvious infectious source. The patient experienced a favorable outcome with no neurological sequelae after receiving treatment with ceftriaxone 2g every 12 h, initiated from the first day of arrival at the emergency department. Conclusions Challenging but achievable, the diagnosis was made by integrating clinical history, microbiological findings, and radiological results. In particular, multiplex PCR played a crucial role in the prompt diagnosis of Escherichia coli K1 meningitis, while also influencing the management and outcome of the patient.

Documents en relation

DI-fusion