[Bacteroides fragilis meningitis revealing a meningorectal fistula].
Cases of meningitis due to Bacteroides fragilis are rare; we report a case revealing a meningorectal fistula.


METHODS
A 2-month-old infant developed a severe sepsis syndrome following a rectosigmoidoscopy for rectal bleeding. Lumbar puncture diagnosed bacterial meningitis. Cerebrospinal fluid (CSF) culture evidenced B fragilis with betalactamase. The initial antibiotherapy was changed for imipenem-metronidazole, which is at present the recommended antibiotherapy. Malformation including pre-spinal tumor and meningorectal fistula was evoked on magnetic resonance imaging (MRI) and confirmed by surgery. The outcome was favorable after surgery and antibiotherapy.


CONCLUSIONS
B fragilis meningitis are usually associated with sepsis, whose origin is obvious. In our case, meningitis was isolated, revealing a meningorectal fistula.
Service de Pédiatrie, CHU, Poitiers, France.
J P
JP
Saulnier
A
A
Nassimi
J
J
Cardona
C
C
Gambert
D
D
Barret
M
M
Berthier
G
G
Levard
D
D
Oriot
D001442:Bacteroides Infections / Q000150:complications*; D001441:Bacteroides fragilis; D006471:Gastrointestinal Hemorrhage; D006801:Humans; D007223:Infant; D008297:Male; D016920:Meningitis, Bacterial / Q000150:complications*; D012003:Rectal Fistula / Q000150:complications* / Q000175:diagnosis*
Méningite à Bacteroides fragilis révélatrice d'une fistule rectoméningée.