title: Mixed Streptococcus pneumoniae and Streptococcus pyogenes meningitis in an immunocompromised adult patient: a case report.
abstract: BACKGROUND
  Community-acquired meningitis is a monomicrobial infection caused by either viruses or bacteria in the vast majority of patients. We report here one exceptional case of a patient with mixed bacterial meningitis due to Streptococcus pneumoniae and Streptococcus pyogenes.
  
  
  METHODS
  We report the case of a 68-year-old immunocompromised Caucasian man suffering from otitis and then meningitis caused by Streptococcus pneumoniae and Streptococcus pyogenes. Bacteria were undistinguishable by direct microscopic examination of the cerebrospinal fluid. He responded well to treatment with cefotaxime and dexamethasone, with no sequelae observed at the 4-month follow-up.
  
  
  CONCLUSIONS
  This first reported case of mixed S. pneumoniae and S. pyogenes meningitis illustrates the life-threatening consequences of barotrauma in immunocompromised patients suffering from otorhinolaryngeal infections.
authors.affiliation: Aix Marseille Université URMITE, UMR CNRS 7278, IRD 198, INSERM 1095, Faculté de Médecine, 27, Boulevard Jean Moulin, 13005, Marseille cedex 5, France.
authors.forename: Clémence
authors.initials: C
authors.lastname: Demerle
authors.affiliation: Service d'Hématologie et Thérapie Cellulaire, Centre Hospitalier Universitaire La Conception, 147 Boulevard Baille, 13005, Marseille cedex 5, France.
authors.forename: Vadim
authors.initials: V
authors.lastname: Ivanov
authors.affiliation: Service d'Hématologie et Thérapie Cellulaire, Centre Hospitalier Universitaire La Conception, 147 Boulevard Baille, 13005, Marseille cedex 5, France.
authors.forename: Cédric
authors.initials: C
authors.lastname: Mercier
authors.affiliation: Service d'Hématologie et Thérapie Cellulaire, Centre Hospitalier Universitaire La Conception, 147 Boulevard Baille, 13005, Marseille cedex 5, France.
authors.forename: Régis
authors.initials: R
authors.lastname: Costello
authors.affiliation: Aix Marseille Université URMITE, UMR CNRS 7278, IRD 198, INSERM 1095, Faculté de Médecine, 27, Boulevard Jean Moulin, 13005, Marseille cedex 5, France. michel.drancourt@univ-amu.fr.|Unité de recherche sur les maladies infectieuses et tropicales émergentes, Faculté de Médecine, 27 Boulevard Jean Moulin, 13385, Marseille cedex 5, France. michel.drancourt@univ-amu.fr.
authors.forename: Michel
authors.initials: M
authors.lastname: Drancourt
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002439:Cefotaxime / Q000008:administration & dosage; D060085:Coinfection / Q000188:drug therapy; D003907:Dexamethasone / Q000008:administration & dosage; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D016920:Meningitis, Bacterial / Q000188:drug therapy* / Q000382:microbiology*; D013296:Streptococcus pneumoniae / Q000302:isolation & purification*; D013297:Streptococcus pyogenes / Q000302:isolation & purification*
chemical_list: D000900:Anti-Bacterial Agents; D003907:Dexamethasone; D002439:Cefotaxime