{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T14:18:51Z","timestamp":1788013131637,"version":"build-2784847793"},"reference-count":22,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2020,11,21]],"date-time":"2020-11-21T00:00:00Z","timestamp":1605916800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infectious Disease Reports"],"abstract":"<jats:p>Bacterial meningitis is an infectious pathology that remains a public health challenge. The most frequent etiological agent is Streptococcus pneumoniae, which is also associated with higher rates of mortality and sequels. However, less is known about the clinical presentation of atypical non-pneumoniae streptococcal meningitis. Here, we studied a 23-year-old man with no medical background who presented with projectile vomiting, states of consciousness alteration, unilateral cranial nerve palsy, and meningeal signs. Neuroimaging showed tonsillar herniation, regions of empyema, right transverse and sigmoid sinuses thrombosis, and multiple arterial subcortical infarcts. Cerebrospinal fluid suggested bacterial infection; blood and abscess cultures were positive for Streptococcus constellatus. The patient received antibiotics with no clinical improvement. He deteriorated over the following days, the abolishment of brainstem reflexes was observed, and brain death was declared. Streptococcal meningitis produced by atypical species is a potential cause of lethal cerebrovascular complications, even in immunocompetent patients.<\/jats:p>","DOI":"10.3390\/idr12030018","type":"journal-article","created":{"date-parts":[[2020,11,23]],"date-time":"2020-11-23T11:50:34Z","timestamp":1606132234000},"page":"87-96","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Atypical Streptococcal Meningitis with Fatal Cerebrovascular Complications: A Case Report"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1149-8193","authenticated-orcid":false,"given":"Gabriel D.","family":"Pinilla-Monsalve","sequence":"first","affiliation":[{"name":"Facultad de Ciencias de la Salud, Icesi University, Calle 18 No. 122\u2013135, Cali 760032, Colombia"},{"name":"Department of Neurology, Fundaci\u00f3n Valle del Lili, Cra. 98 No. 18\u201349, Cali 760032, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel F.","family":"Torres-Cutiva","sequence":"additional","affiliation":[{"name":"Facultad de Ciencias de la Salud, Icesi University, Calle 18 No. 122\u2013135, Cali 760032, Colombia"},{"name":"Department of Internal Medicine, Fundaci\u00f3n Valle del Lili, Cra. 98 No. 18\u201349, Cali 760032, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan P.","family":"Fern\u00e1ndez-Cubillos","sequence":"additional","affiliation":[{"name":"Facultad de Ciencias de la Salud, Icesi University, Calle 18 No. 122\u2013135, Cali 760032, Colombia"},{"name":"Department of Neurology, Fundaci\u00f3n Valle del Lili, Cra. 98 No. 18\u201349, Cali 760032, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,11,21]]},"reference":[{"key":"ref_1","unstructured":"Institute for Health Metrics and Evaluation (2019, December 20). Global Burden of Disease (GBD) Results Tool. Available online: http:\/\/ghdx.healthdata.org\/gbd-results-tool."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Instituto Nacional de Salud (2019, December 20). Bolet\u00edn Epidemiol\u00f3gico Semanal: Semana epidemiol\u00f3gica 15, Bogot\u00e1 D.C.: Ministerio de Salud de Colombia, Available online: http:\/\/www.ins.gov.co\/buscador-eventos\/BoletinEpidemiologico\/2019_Bolet\u00edn_epidemiol\u00f3gico_semana_15.pdf.","DOI":"10.33610\/23576189.2019.15"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1016\/S1474-4422(18)30387-9","article-title":"Global, regional, and national burden of meningitis, 1990\u20132016: A systematic analysis for the Global Burden of Disease Study 2016","volume":"17","author":"Zunt","year":"2018","journal-title":"Lancet Neurol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1136\/pgmj.2010.097022","article-title":"Role of imaging in the diagnosis of acute bacterial meningitis and its complications","volume":"86","author":"Hughes","year":"2010","journal-title":"Postgrad. Med J."},{"key":"ref_5","first-page":"5","article-title":"Bacterial meningitis and neurological complications in adults","volume":"4","author":"Julayanont","year":"2016","journal-title":"Southwest Respir. Crit. Care Chron."},{"key":"ref_6","unstructured":"Gideon Online (2019, December 20). Cerebrospinal meningitis. Worldwide diseases distribution. Los Angeles: GIDEON Informatics, Available online: http:\/\/web.gideonoline.com\/web\/epidemiology\/index.php?disease=11480&country=G100#."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Yau, B., Hunt, N.H., Mitchell, A.J., and Too, L.K. (2018). Blood\u2012Brain Barrier Pathology and CNS Outcomes in Streptococcus pneumoniae Meningitis. Int. J. Mol. Sci., 19.","DOI":"10.3390\/ijms19113555"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1007\/s12028-010-9387-5","article-title":"Diffuse Cerebral Intravascular Coagulation and Cerebral Infarction in Pneumococcal Meningitis","volume":"13","author":"Vergouwen","year":"2010","journal-title":"Neurocritical Care"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.jinf.2016.04.009","article-title":"Neurological sequelae of bacterial meningitis","volume":"73","author":"Lucas","year":"2016","journal-title":"J. Infect."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"866","DOI":"10.1007\/s00134-012-2792-9","article-title":"Delayed cerebral thrombosis in bacterial meningitis: A prospective cohort study","volume":"39","author":"Lucas","year":"2012","journal-title":"Intensiv. Care Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e811","DOI":"10.1097\/CCM.0000000000003220","article-title":"Delayed Cerebral Injury in Adults with Bacterial Meningitis","volume":"46","author":"Gallegos","year":"2018","journal-title":"Crit. Care Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1093\/brain\/awg113","article-title":"Pneumococcal meningitis in adults: Spectrum of complications and prognostic factors in a series of 87 cases","volume":"126","author":"Kastenbauer","year":"2003","journal-title":"Brain"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1080\/00365540210147886","article-title":"Venous Sinus Thrombosis After Proteus Vulgaris Meningitis and Concomitant Clostridium abscess Formation","volume":"34","author":"Bodur","year":"2002","journal-title":"Scand. J. Infect. Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1016\/j.jpeds.2015.02.014","article-title":"Late-Onset Group B Streptococcal Meningitis Has Cerebrovascular Complications","volume":"166","author":"Tibussek","year":"2015","journal-title":"J. Pediatr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2453","DOI":"10.1007\/s10096-012-1589-7","article-title":"Milleri group Streptococcus\u2014A stepchild in the viridans family","volume":"31","author":"Azmon","year":"2012","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_16","first-page":"279","article-title":"Meningitis and brain abscess caused by streptococcus intermedius in a patient infected with HIV-1","volume":"22","author":"Morales","year":"2005","journal-title":"An. Med. Interna"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1097\/INF.0b013e3182748fe9","article-title":"Presumed Hydrogen Sulfide-mediated Neurotoxicity After Streptococcus anginosus Group Meningitis","volume":"32","author":"Verma","year":"2013","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1099\/mic.0.075580-0","article-title":"A streptolysin S homologue is essential for \u03b2-haemolytic Streptococcus constellatus subsp. constellatus cytotoxicity","volume":"160","author":"Tabata","year":"2014","journal-title":"Microbiology"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1080\/00365549950163824","article-title":"Meningitis Caused by Streptococci Other than Streptococcus pneumoniae: A Retrospective Clinical Study","volume":"31","year":"1999","journal-title":"Scand. J. Infect. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1157\/13088778","article-title":"Bacteriemia, pneumon\u00eda and meningitis due to Streptococcus constellatum","volume":"126","author":"Cabo","year":"2006","journal-title":"Med. Clin."},{"key":"ref_21","unstructured":"Stratton, C.W. (2019). Infections due to the Streptococcus anginosus (Streptococcus milleri) Group, UpToDate. Available online: https:\/\/www.uptodate.com."},{"key":"ref_22","first-page":"494","article-title":"Infection related cerebral venous thrombosis","volume":"56","author":"Kojan","year":"2006","journal-title":"J. Pak. Med. 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