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).