Journal
INTERNAL MEDICINE
Volume 57, Issue 21, Pages 3199-3204Publisher
JAPAN SOC INTERNAL MEDICINE
DOI: 10.2169/internalmedicine.0795-18
Keywords
bacterial meningitis; ESBL-producing E. coli; otitis media with cholesteatoma
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A 78-year-old man had a fever and exhibited disordered consciousness, which led to his transportation to our hospital. On arrival, he exhibited discharge from the ear. Because extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli was detected in the ear discharge and cerebrospinal fluid specimens, it was inferred to be the causal bacteria. Pulsed-field gel electrophoresis indicated the same ESBL-producing E. coli pattern in the patient's ear discharge, external auditory canal granulation, cerebrospinal fluid, and stool, indicating their common molecular epidemiological origin. Although ESBL-producing E. coli is an extremely rare cause of bacterial meningitis, it should be considered as a potential causal bacteria for community-acquired meningitis.
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