Isolated bacterial meningitis as the key syndrome of infective endocarditis.
BACKGROUND
Bacterial meningitis is an unusual first manifestation but a major complication of infective endocarditis.


METHODS
We present three well documented cases of isolated bacterial meningitis in endocarditis. Against this background we review the literature.


RESULTS
All patients presented with bacterial meningitis. Staphylococcus aureus was isolated in blood cultures of all patients, but was found only in the cerebrospinal fluid (CSF) of one patient. The underlying endocarditis was confirmed histologically in all three cases. Two patients recovered completely and one died.


CONCLUSIONS
An extensive search for endocarditis is recommended in every case of an unusual isolate in bacterial meningitis whether it is isolated from blood or CSF.
Dept. of Neurology, Charité, Humboldt-University, D-10098, Berlin, Germany. klemens.angstwurm@charite.de
K
K
Angstwurm
E
E
Halle
K
K
Wetzel
J
J
Schultze
E
E
Schielke
J R
JR
Weber
D000368:Aged; D000900:Anti-Bacterial Agents; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D017548:Echocardiography, Transesophageal / Q000379:methods; D004697:Endocarditis, Bacterial / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D016920:Meningitis, Bacterial / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D018570:Risk Assessment; D018805:Sepsis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D012720:Severity of Illness Index; D013203:Staphylococcal Infections / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents