Introduction
Acute bacterial meningitis is a potentially life-threatening condition and in adults is most often caused by Streptococcus pneumoniaeand Neisseria meningitidis . Among other pathogens that cause bacterial meningitis, gram-negative bacilli (GNB) are an uncommon cause, ranging from 0.7 to 7% across the world [1].
Escherichia coli (E. coli ) is a commensal bacteria within the human gut. However certain strains are associated with infections that urinary tract infection is the most presentation. Other manifestations are nosocomial pneumonia, cholecystitis, peritonitis, cellulitis, osteomyelitis and septic arthritis [2]. E. colirepresents a rare cause of community-acquired meningitis in adults comprising about 1 % of meningitis cases and occur almost always in cases with an underlying risk factor, such as diabetes mellitus, alcoholism, cirrhosis, HIV infection and malignancies. This is usually secondary to a distant or contiguous focus of infection, such as urinary tract or gastrointestinal infection [3, 4]. Here we report a case of acute community-acquired meningitis which resulted from the hematogenous spread of E. coli emphysematous pyelonephritis in a 53-year-old diabetic woman with immune thrombocytopenic purpura (ITP).