Meningitis Caused by Enterococcus gallinarum in an Immunocompetent Host

Enterococci are unusual etiological agents of bacterial meningitis. Meningitis caused by Enterococcus gallinarum, especially those that occur in immunocompetent hosts, is extremely rare. Moreover, community-acquired E. gallinarum meningitis might be extremely unexpected for a clinician and therefore easily misdiagnosed and mistreated.

A 12-year-old boy presented with an acute onset of fever, headache and vomiting. The cerebrospinal fluid culture from lumbar puncture yielded an isolate that was identified as E. gallinarum. The therapeutic regimen was a combination therapy of rifampicin and high-dose intravenous penicillin. One day after starting treatment, the patient became afebrile. A repeated lumber puncture two weeks later showed few white blood cells in the CSF and no bacterial growth.

This case reveals an incident of meningitis caused by E. gallinarum in an immunocompetent host. The combined therapy of rifampicin and high-dose intravenous penicillin might be effective for treatment in such a case.