{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T05:18:17Z","timestamp":1787894297631,"version":"build-2784847793"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Streptococcus suis<\/jats:italic>\n                      (\n                      <jats:italic>S. suis<\/jats:italic>\n                      ) meningitis is a severe zoonotic central nervous system infection, with permanent sensorineural hearing loss as its most common long-term sequela. Hydrocephalus is an extremely rare and underrecognized complication of\n                      <jats:italic>S. suis<\/jats:italic>\n                      meningitis, and no case of communicating hydrocephalus secondary to\n                      <jats:italic>S. suis<\/jats:italic>\n                      meningitis managed successfully with non-neurosurgical therapy has been formally documented.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>\n                      A 52-year-old man presented with 8 days of progressive dizziness and gait imbalance. Contrast-enhanced magnetic resonance imaging (MRI) confirmed communicating hydrocephalus with diffuse leptomeningeal enhancement and no ventricular obstruction. Cerebrospinal fluid (CSF) cultures remained persistently negative, while metagenomic next-generation sequencing (mNGS) identified\n                      <jats:italic>S. suis<\/jats:italic>\n                      within 48\u2005h with a relative abundance of 92.60%. Guideline-recommended targeted antimicrobial therapy combined with short-course adjunctive dexamethasone achieved complete clinical and radiological resolution without neurosurgical intervention. The patient remained asymptomatic with intact bilateral hearing at the 10-month follow-up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      To our knowledge, this is the first reported case of\n                      <jats:italic>S. suis<\/jats:italic>\n                      meningitis-associated communicating hydrocephalus successfully managed without neurosurgery. Accurate hydrocephalus subtyping via contrast-enhanced MRI and rapid pathogen identification via mNGS may help inform clinical decision-making regarding the potential for non-neurosurgical management in carefully selected patients.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1888345","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T04:33:03Z","timestamp":1787891583000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Streptococcus suis meningitis complicated with communicating hydrocephalus: complete clinical and radiological resolution with non-neurosurgical management\u2014A case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Mei","family":"Qi","sequence":"first","affiliation":[{"name":"Xiaolan Clinical Institute of Shantou University Medical College","place":["Zhongshan, Guangdong, China"]},{"name":"Department of 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