title: Clostridium perfringens meningitis, Plesiomonas shigelloides sepsis: A lethal combination.
abstract: BACKGROUND
  Anaerobic bacterial meningitis is rare. It is extremely unusual without a portal of entry as most cases reported have been associated with trauma or neurosurgery.
  
  
  METHODS
  We describe this rare case of clostridium meningitis and plesiomonas sepsis in an immunocompetent adult. A 71 year old man with diabetes presented with acute onset severe headaches, obtundation and signs of severe hemolysis following a 2 week game hunting trip in the Swiss Alps. His clinical status progressed rapidly; he died 3 hours after initial presentation. Post mortem lumbar puncture was performed with CSF analysis suggestive of bacterial meningitis. Clostridium perfringens was eventually recovered from the CSF as well as in the blood. Plesiomonas shigelloides was recovered from the blood as well.
  
  
  CONCLUSIONS
  This is the first case of blood stream infection with these two organisms in a single patient without an obvious portal of entry.
authors.affiliation: Division of Infectious Diseases, Beth Israel Medical Center, Newark, NJ, U.S.A.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Okon
authors.forename: Eliahu
authors.initials: E
authors.lastname: Bishburg
authors.forename: Sandra
authors.initials: S
authors.lastname: Ugras
authors.forename: Trini
authors.initials: T
authors.lastname: Chan
authors.forename: He
authors.initials: H
authors.lastname: Wang
keywords: clostridium perfringens; hemolysis; meningitis; plesiomonas; sepsis