{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T06:59:41Z","timestamp":1781765981180,"version":"3.54.5"},"reference-count":37,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,3,30]],"date-time":"2023-03-30T00:00:00Z","timestamp":1680134400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Sphingomonas paucimobilis is a gram-negative bacillus that is widely distributed in the environment but rarely causes infections in humans. Meningitis caused by S. paucimobilis is an extremely rare clinical entity with very few reported cases in the literature. The clinical presentation and management of S. paucimobilis meningitis are not well established, and further research is needed to better understand this rare infection. Therefore, the goal of this study was to present probably the only case of meningitis caused by co-infection with S. paucimobilis and Mycobacterium tuberculosis and to describe the diagnostic and therapeutic challenges encountered, in correlation with the other very few reported cases of S. paucimobilis meningitis. A 64-year-old male farmer residing in a rural area was admitted with symptoms of severe headache, somnolence, and confusion. He had several comorbidities, including adrenal insufficiency, duodenal ulcer, and hypercholesterolemia. Lumbar puncture showed elevated leukocyte counts, glucose, and a marked rise of cerebrospinal fluid (CSF) proteins, indicating bacterial meningitis, which was confirmed by CSF culture that isolated S. paucimobilis and Mycobacterium tuberculosis. Antituberculosis therapy was initiated with isoniazid (300 mg\/day), rifampicin (600 mg\/day), pyrazinamide (2000 mg\/day), and streptomycin (1 g\/day). Ceftriaxone was introduced nine days later, after CSF culture grew S. paucimobilis, and was discharged without complications after 40 days of hospitalization. The literature search revealed a total of 12 published cases of S. paucimobilis meningitis in patients ranging from two months old to 66 years old. Among these cases, eight (66%) reported a favorable outcome, while two (17%) cases resulted in a poor outcome, and two (17%) were fatal. It was observed among the 13 identified cases (including ours) that the CSF white blood cell count had an average of 178.9 \u00d7 103\/mm3, an average glucose level of 33.0 mg\/dL, and an average protein count of 294.2 mg\/dL. Most cases improved appropriately under antibiotic therapy with intravenous ceftriaxone, Meropenem, and Vancomycin. In conclusion, although extremely rare, S. paucimobilis meningitis has good outcomes even in immunocompromised patients with appropriate antibiotic therapy and close monitoring, while the diagnosis should not be excluded even in immunocompetent patients.<\/jats:p>","DOI":"10.3390\/medicina59040687","type":"journal-article","created":{"date-parts":[[2023,3,30]],"date-time":"2023-03-30T03:17:35Z","timestamp":1680146255000},"page":"687","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Concurrent Sphingomonas paucimobilis and Mycobacterium tuberculosis Meningitis in an Immunocompromised Patient: A Rare Case Report and Comprehensive Review of Literature"],"prefix":"10.3390","volume":"59","author":[{"given":"Iosif","family":"Marincu","sequence":"first","affiliation":[{"name":"Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4711-4315","authenticated-orcid":false,"given":"Felix","family":"Bratosin","sequence":"additional","affiliation":[{"name":"Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iulia","family":"Bogdan","sequence":"additional","affiliation":[{"name":"Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catalin","family":"Dumitru","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen Nicoleta","family":"Stoica","sequence":"additional","affiliation":[{"name":"Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrei Nicolae","family":"Csep","sequence":"additional","affiliation":[{"name":"Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Narcisa","family":"Mederle","sequence":"additional","affiliation":[{"name":"Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0776-0809","authenticated-orcid":false,"given":"Roxana Manuela","family":"Fericean","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2242-7764","authenticated-orcid":false,"given":"Alexandru Ovidiu","family":"Mederle","sequence":"additional","affiliation":[{"name":"Department of Surgery, Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reshmanth","family":"Prathipati","sequence":"additional","affiliation":[{"name":"Santiram Medical College and General Hospital, Nandyala 518001, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gratiana Nicoleta","family":"Chicin","sequence":"additional","affiliation":[{"name":"Faculty of General Medicine, \u201cVasile Goldis\u201d Western University of Arad, Bulevardul Revolutiei 94, 310025 Arad, Romania"},{"name":"National Institute of Public Health, Strada Doctor Leonte Anastasievici 1-3, 050463 Bucuresti, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adelina","family":"Mavrea","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Cardiology Clinic, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0009-9875","authenticated-orcid":false,"given":"Paula Irina","family":"Barata","sequence":"additional","affiliation":[{"name":"Department of Physiology, Faculty of Medicine, \u201cVasile Goldis\u201d Western University of Arad, Revolutiei Square 94, 310025 Arad, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0287-5938","authenticated-orcid":false,"given":"Adrian Vasile","family":"Bota","sequence":"additional","affiliation":[{"name":"Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1097\/WCO.0000000000000934","article-title":"Acute bacterial meningitis","volume":"34","author":"Wall","year":"2021","journal-title":"Curr. 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