{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T17:48:48Z","timestamp":1755798528149,"version":"3.44.0"},"reference-count":12,"publisher":"SMC Media","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Background:\u00a0Community-acquired bacterial meningitis in adults represents one of the most severe infectious diseases worldwide with potentially life-threatening medical complications. Several infectious agents can cause acute meningitis. Although group B\u00a0Streptococcus\u00a0is more prevalent in newborns, infection can also lead to meningitis in older adults, particularly those with underlying health issues. Case Description:\u00a0A 53-year-old woman with a body mass index of 28.7 kg\/m2, type 2 diabetes mellitus, and dyslipidaemia presented to the emergency department of Santa Maria della Stella Hospital (Orvieto, Italy) with confusion, low-grade fever, echolalia, and hyperglycaemia. Computed tomography scans of the brain revealed a hypodensity in the left anterior frontal lobe and an osteodural defect of the rhinobase. Meningitis was suspected and empiric broad-spectrum antibiotic therapy with corticosteroids and insulin were administered while the results of the cerebrospinal fluid analysis confirmed the diagnosis of group B\u00a0Streptococcus\u00a0meningitis. Repeat imaging at 48 hours revealed enlargement of the hypodense lesion. The frontal assessment battery indicated deficits in executive functions. Prompt treatment led to rapid clinical improvement. Following the restoration of euglycemic status and hemodynamic stabilization, a follow-up magnetic resonance imaging confirmed the ischaemic lesion and showed cerebrospinal fluid in the sella turcica. The patient was then transferred to neurorehabilitation. Conclusions:\u00a0The complex interactions among multiple risk factors resulted in an atypical clinical case of group B\u00a0Streptococcus\u00a0meningitis, which was promptly treated with empiric antibiotic therapy to mitigate neurocognitive deficits.<\/jats:p>","DOI":"10.12890\/2024_004514","type":"journal-article","created":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T04:48:51Z","timestamp":1713242931000},"source":"Crossref","is-referenced-by-count":0,"title":["Group B Streptococcus meningitis in an adult woman with type 2 diabetes and ethmoid roof defect. Impact on \u201cfrontal\u201d cognitive functions"],"prefix":"10.12890","volume":"11","author":[{"given":"Roberto","family":"Vicinanza","sequence":"first","affiliation":[{"name":"Leonard Davis School of Gerontology, University of Southern California, Los Angeles, USA; Department of Clinical, Internal, Anesthesiological, and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice","family":"Miscetti","sequence":"first","affiliation":[{"name":"Department of Emergency, Santa Maria della Stella Hospital, Orvieto, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cesare","family":"Magistrato","sequence":"first","affiliation":[{"name":"Department of Emergency, Santa Maria della Stella Hospital, Orvieto, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melina","family":"Castiglione","sequence":"first","affiliation":[{"name":"UOC Neurosurgery, Fabrizio Spaziani Hospital, Frosinone, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Frizza","sequence":"first","affiliation":[{"name":"Department of Emergency, Santa Maria della Stella Hospital, Orvieto, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10397","published-online":{"date-parts":[[2024,4,16]]},"reference":[{"key":"10.12890\/2024_004514_ref1","doi-asserted-by":"crossref","unstructured":"<li>Akaishi T, Tarasawa K, Fushimi K, Yaegashi N, Aoki M, Fujimori K. Demographic profiles and risk factors for mortality in acute meningitis: A nationwide population-based observational study. <em>Acute Med Surg<\/em> 2023;<strong>11<\/strong>:e920. <\/li>","DOI":"10.1002\/ams2.920"},{"key":"10.12890\/2024_004514_ref2","unstructured":"<li>Wunrow HY, Bender RG, Vongpradith A, Sirota SB, Swetschinski LR, Novotney A, et al. Global, regional, and national burden of meningitis and its aetiologies, 1990\u20132019: a systematic analysis for the Global Burden of Disease Study 2019. <em>Lancet Neurol<\/em> 2023;<strong>22<\/strong>:685\u2013711. <\/li>"},{"key":"10.12890\/2024_004514_ref3","doi-asserted-by":"crossref","unstructured":"<li>van Kassel MN, Bijlsma MW, Brouwer MC, van der Ende A, van de Beek D. Community-acquired group B streptococcal meningitis in adults: 33 cases from prospective cohort studies. <em>J Infect<\/em> 2019;<strong>78<\/strong>:54\u201357. <\/li>","DOI":"10.1016\/j.jinf.2018.07.009"},{"key":"10.12890\/2024_004514_ref4","doi-asserted-by":"crossref","unstructured":"<li>Ma A, Thompson LA, Corsiatto T, Hurteau D, Tyrrell GJ. Epidemiological Characterization of Group B Streptococcus Infections in Alberta, Canada: An Update from 2014 to 2020. <em>Microbiol Spectr<\/em> 2021:e01283-21. <\/li>","DOI":"10.1128\/Spectrum.01283-21"},{"key":"10.12890\/2024_004514_ref5","doi-asserted-by":"crossref","unstructured":"<li>Dando SJ, Mackay-Sim A, Norton R, Currie BJ, St. John JA, Ekberg JAK, et al. Pathogens Penetrating the Central Nervous System: Infection Pathways and the Cellular and Molecular Mechanisms of Invasion. <em>Clin Microbiol Rev<\/em> 2014;<strong>27<\/strong>:691\u2013726. <\/li>","DOI":"10.1128\/CMR.00118-13"},{"key":"10.12890\/2024_004514_ref6","doi-asserted-by":"crossref","unstructured":"<li>van Veen KEB, Brouwer MC, van der Ende A, van de Beek D. Bacterial meningitis in diabetes patients: a population-based prospective study. <em>Sci Rep<\/em> 2016;<strong>6<\/strong>:36996. <\/li>","DOI":"10.1038\/srep36996"},{"key":"10.12890\/2024_004514_ref7","doi-asserted-by":"crossref","unstructured":"<li>Mota RI, Morgan SE, Bahnson EM. Diabetic Vasculopathy: Macro and Microvascular Injury. <em>Curr Pathobiol Rep<\/em> 2020;<strong>8<\/strong>:1\u201314. <\/li>","DOI":"10.1007\/s40139-020-00205-x"},{"key":"10.12890\/2024_004514_ref8","doi-asserted-by":"crossref","unstructured":"<li>Beuker C, Werring N, Bonberg N, Strecker JK, Schmidt-Pogoda A, Schwindt W, et al. Stroke in Patients with Bacterial Meningitis: A Cohort Study and Meta-Analysis. <em>Ann Neurol<\/em> 2023;<strong>93<\/strong>:1094\u20131105. <\/li>","DOI":"10.1002\/ana.26618"},{"key":"10.12890\/2024_004514_ref9","doi-asserted-by":"crossref","unstructured":"<li>van Kassel MN, van Haeringen KJ, Brouwer MC, Bijlsma MW, van de Beek D. Community-acquired group B streptococcal meningitis in adults. <em>J Infect<\/em> 2020;<strong>80<\/strong>:255\u2013260. <\/li>","DOI":"10.1016\/j.jinf.2019.12.002"},{"key":"10.12890\/2024_004514_ref10","doi-asserted-by":"crossref","unstructured":"<li>Keogh RA, Doran KS. Group B Streptococcus and diabetes: Finding the sweet spot. <em>PLoS Pathog<\/em> 2023;<strong>19<\/strong>:e1011133. <\/li>","DOI":"10.1371\/journal.ppat.1011133"},{"key":"10.12890\/2024_004514_ref11","doi-asserted-by":"crossref","unstructured":"<li>Bernal-Sprekelsen M, Rioja E, Ensenat J, Enriquez K, Viscovich L, Agredo-Lemos FE, et al. Management of Anterior Skull Base Defect Depending on Its Size and Location. <em>Biomed Res Int<\/em> 2014;<strong>2014<\/strong>:e346873. <\/li>","DOI":"10.1155\/2014\/346873"},{"key":"10.12890\/2024_004514_ref12","doi-asserted-by":"crossref","unstructured":"<li>Schuknecht B, Simmen D, Briner HR, Holzmann D. Nontraumatic Skull Base Defects With Spontaneous CSF Rhinorrhea and Arachnoid Herniation: Imaging Findings and Correlation With Endoscopic Sinus Surgery in 27 Patients. <em>Am J Neuroradiol<\/em> 2008;<strong>29<\/strong>:542\u2013549. <\/li>","DOI":"10.3174\/ajnr.A0840"}],"container-title":["European Journal of Case Reports in Internal Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/4514\/3962","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/4514\/3963","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/4514\/3963","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T10:32:39Z","timestamp":1755599559000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/view\/4514"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,16]]},"references-count":12,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.12890\/2024_004514","relation":{"has-manifestation":[{"id-type":"other","id":"1-112-4514-g3962","asserted-by":"subject"},{"id-type":"other","id":"1-112-4514-g3963","asserted-by":"subject"}],"is-part-of":[{"id-type":"other","id":"1-112","asserted-by":"subject"}]},"ISSN":["2284-2594"],"issn-type":[{"type":"electronic","value":"2284-2594"}],"subject":[],"published":{"date-parts":[[2024,4,16]]}}}