Community-acquired Streptococcus mitis meningitis: a case report

Background: Streptococcus mitis is prevalent in the normal flora of the oropharynx, the female genital tract, gastrointestinal tract, and skin. Although it is usually considered to have low virulence and pathogenicity, Streptococcus mitis may cause life-threatening infections, particularly endocarditis. Meningitis with S. mitis is rare, but has been described in individuals with previous spinal anesthesia, neurosurgical procedure, malignancy, or neurological complications of endocarditis. Case report: A 58-year-old, alcoholic male patient with a high fever, headache, and changes in mental status was admitted to hospital with the diagnosis of meningitis. S. mitis, isolated from cerebrospinal fluid, was sensitive to penicillin. He was given a 14-day course of ampicillin and made a full clinical recovery. Conclusions: The purpose of this report is to emphasize the importance of the occurrence of S. mitis meningitis in patients with concomitant factors such as older age (>50 years), alcoholism, poor oral hygiene, and maxillary sinusitis. (C) 2008 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.