{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T03:54:45Z","timestamp":1793073285609,"version":"4.5.0"},"reference-count":55,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T00:00:00Z","timestamp":1691366400000},"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>Polymicrobial meningitis is a rare entity in the adult population, especially in the antibiotic era. However, disorders such as chronic suppurative otitis media (CSOM) or even poor oral hygiene are considered risk factors for the development of such cerebral infection. We report a case of polymicrobial meningitis associated with oto-mastoiditis in a 64-year-old female patient known to have CSOM. The patient presented atypical symptoms for community-acquired meningitis, showing subacute evolution of headache, without fever or neck stiffness. The aerobe microorganisms Streptococcus anginosus and Corynebacterium spp., sensitive to beta-lactamines, and the anaerobe Prevotella spp., resistant to penicillin and metronidazole, were isolated from CSF specimens, while Proteus mirabilis and Enterococcus faecalis were identified from the ear drainage. The diversity of pathogens identified in our case led us to the hypothesis of two different sources of meningitis: otogenic and\/or odontogenic. Favorable evolution was obtained after a multi-disciplinary approach, combining surgery and broad-spectrum antibiotics. In addition, we performed a literature review that highlights the low incidence of polymicrobial mixed aerobe\u2013anaerobe meningitis.<\/jats:p>","DOI":"10.3390\/medicina59081428","type":"journal-article","created":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T06:37:31Z","timestamp":1691390251000},"page":"1428","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Polymicrobial Bacterial Meningitis in a Patient with Chronic Suppurative Otitis Media: Case Report and Literature Review"],"prefix":"10.3390","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8357-7048","authenticated-orcid":false,"given":"Andrei","family":"V\u00e2\u0163\u0103","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy of Iasi, 16 Universitatii Street, 700115 Iasi, Romania"},{"name":"Clinic of Infectious Diseases, \u201cSf. Parascheva\u201d Clinical Hospital of Infectious Diseases, 700116 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika","family":"Irimie-B\u0103lu\u0163\u0103","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy of Iasi, 16 Universitatii Street, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florin Manuel","family":"Ro\u015fu","sequence":"additional","affiliation":[{"name":"Clinic of Infectious Diseases, \u201cSf. Parascheva\u201d Clinical Hospital of Infectious Diseases, 700116 Iasi, Romania"},{"name":"Department of Dento-Alveolar Surgery, Anesthesia, Sedation, and Medical-Surgical Emergencies, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioana Maria","family":"Onofrei","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy of Iasi, 16 Universitatii Street, 700115 Iasi, Romania"},{"name":"Clinic of Infectious Diseases, \u201cSf. Parascheva\u201d Clinical Hospital of Infectious Diseases, 700116 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabela Ioana","family":"Loghin","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy of Iasi, 16 Universitatii Street, 700115 Iasi, Romania"},{"name":"Clinic of Infectious Diseases, \u201cSf. Parascheva\u201d Clinical Hospital of Infectious Diseases, 700116 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5308-7192","authenticated-orcid":false,"given":"Mihaela","family":"Per\u0163ea","sequence":"additional","affiliation":[{"name":"Department of Surgery 1, Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy of Iasi, 16 Universitatii Street, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrei Nicolae","family":"Av\u0103danei","sequence":"additional","affiliation":[{"name":"Vascular Surgery Department, \u201cSf. Spiridon\u201d Emergency Hospital, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihnea","family":"Miron","sequence":"additional","affiliation":[{"name":"Intensive Care Department, \u201cSf. Spiridon\u201d Emergency Hospital, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lumini\u0163a","family":"R\u0103dulescu","sequence":"additional","affiliation":[{"name":"ENT Surgery Department, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5148-8769","authenticated-orcid":false,"given":"Irina","family":"E\u015fanu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy of Iasi, 16 Universitatii Street, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u0103t\u0103lina Mihaela","family":"Luca","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy of Iasi, 16 Universitatii Street, 700115 Iasi, Romania"},{"name":"Clinic of Infectious Diseases, \u201cSf. Parascheva\u201d Clinical Hospital of Infectious Diseases, 700116 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"840910","DOI":"10.3389\/fmed.2022.840910","article-title":"Polymicrobial Anaerobic Meningitis Detected by Next-Generation Sequencing: Case Report and Review of the Literature","volume":"9","author":"Li","year":"2022","journal-title":"Front. Med."},{"key":"ref_2","first-page":"1346895","article-title":"Fatal Meningitis in a 14-Month-Old with Currarino Triad","volume":"2016","author":"Aljoqiman","year":"2016","journal-title":"Case Rep. 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