{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T05:00:09Z","timestamp":1790312409921,"version":"4.1.0"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"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:p>\n                    <jats:italic>Streptococcus suis<\/jats:italic>\n                    is a common zoonotic pathogen that usually causes monomicrobial meningitis. Occult bloodstream detection of\n                    <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                    , together with proven central-nervous-system\n                    <jats:italic>S. suis<\/jats:italic>\n                    infection, followed by irreversible cochlear fibrotic changes requiring cochlear implantation, appears exceptionally rare. We report a 52-year-old male with chronic heavy alcohol intake and occupational swine-exposure history who developed severe sepsis, recurrent suppurative meningoencephalitis caused by\n                    <jats:italic>S. suis<\/jats:italic>\n                    , and permanent bilateral labyrinthine-related deafness. Combined blood and cerebrospinal fluid (CSF) metagenomic next-generation sequencing (mNGS) identified suspected additional bloodstream infection by\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    , although\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    was not detected in CSF. Multimodal antimicrobial, anti-inflammatory, and immunomodulatory therapy cleared intracranial infection but failed to restore hearing. Preoperative imaging suggested cochlear fibrotic changes; left-sided cochlear implantation achieved full electrode insertion with stable intraoperative neural responses despite abundant intracochlear fibrous tissue observed intraoperatively. This case raises three important considerations: occupational swine exposure together with chronic alcoholism may plausibly contribute to suspected polymicrobial sepsis; in selected patients, peripheral-blood mNGS may help identify occult Gram-negative bacteremia when CSF assays remain negative during recurrent meningitis; and cochlear fibrosis may not absolutely preclude technically-successful cochlear implantation.\n                  <\/jats:p>","DOI":"10.3389\/fmed.2026.1941314","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T04:27:52Z","timestamp":1790310472000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Streptococcus suis-associated meningoencephalitis with profound bilateral labyrinthine deafness and intra-operative cochlear fibrosis treated by cochlear implantation"],"prefix":"10.3389","volume":"13","author":[{"given":"Lingping","family":"Ding","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, West China Hospital, Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, West China Hospital, Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fanghua","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pathology, Sichuan Provincial People\u2019s Hospital, University of Electronic Science and Technology of China","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"13358","DOI":"10.1038\/s41598-018-31598-w","article-title":"Risk factors for Streptococcus suis infection: a systematic review and meta-analysis","volume":"8","author":"Rayanakorn","year":"2018","journal-title":"Sci Rep"},{"key":"B2","doi-asserted-by":"publisher","first-page":"544","DOI":"10.1016\/j.jiac.2023.11.017","article-title":"Streptococcus suis meningoencephalitis diagnosed with metagenomic next-generation sequencing: a case report with literature review","volume":"30","author":"Jiang","year":"2024","journal-title":"J Infect Chemother"},{"key":"B3","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1080\/00016489.2323650","article-title":"Cochlear implantation in patients with Streptococcus suis meningitis: clinical characteristics and postoperative evaluation","volume":"144","author":"Chen","year":"2024","journal-title":"Acta Otolaryngol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1080\/14670100.2524953","article-title":"Surgical technique protocol for cochlear implantation in post-meningitic ossified cochlea","volume":"26","author":"Dutt","year":"2025","journal-title":"Cochlear Implants Int"},{"key":"B5","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1016\/j.micpath.2013.08.006","article-title":"Alcohol consumption promotes the intestinal translocation of Streptococcus suis infections","volume":"65","author":"Nakayama","year":"2013","journal-title":"Microb Pathog"},{"key":"B6","doi-asserted-by":"publisher","first-page":"e10","DOI":"10.1093\/cid\/ciu444","article-title":"Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America","volume":"59","author":"Stevens","year":"2014","journal-title":"Clin Infect Dis"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1693","DOI":"10.1016\/S0140-6736(12)61186-6","article-title":"Advances in treatment of bacterial meningitis","volume":"380","author":"van de Beek","year":"2012","journal-title":"Lancet"},{"key":"B8","doi-asserted-by":"publisher","first-page":"2327","DOI":"10.1056\/NEJMoa1803396","article-title":"Clinical metagenomic sequencing for diagnosis of meningitis and encephalitis","volume":"380","author":"Wilson","year":"2019","journal-title":"N Engl J Med"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1267","DOI":"10.1086\/425368","article-title":"Practice guidelines for the management of bacterial meningitis","volume":"39","author":"Tunkel","year":"2004","journal-title":"Clin Infect Dis"},{"key":"B10","doi-asserted-by":"publisher","first-page":"683","DOI":"10.26444\/aaem\/79813","article-title":"Streptococcus suis: a re-emerging pathogen associated with occupational exposure to pigs or pork products. 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