Abstract

Dr. Iraqui Houssaini Zineb*, Wali Alami Mohamed, Hadi Imane, Pr. Benouda Amina

ABSTRACT

Bacterial meningitis is a severe infection of the central nervous system, necessitating prompt intervention to prevent serious complications. While Streptococcus pneumoniae is a commonly encountered pathogen in adult meningitis, Streptococcus pyogenes is a much rarer etiology. This summary addresses two atypical cases of streptococcal meningitis in adults, each presenting distinct diagnostic challenges. The first case involves a 50-year-old woman with chronic lymphocytic leukemia (CLL), admitted with altered consciousness, fever, and sepsis. Cerebrospinal fluid (CSF) analysis revealed hypoglycorrhachia accompanied by lymphocytic predominance, an unusual presentation for S. pneumoniae meningitis. This observation, when associated with CLL, might suggest meningeal infiltration by leukemic cells, a rare phenomenon. The second case concerns a 22-year-old man who developed headaches and fever following head trauma. Lumbar puncture revealed a predominance of neutrophils and the presence of Gram-positive cocci, identifying S. pyogenes as the causative agent. While this pathogen is generally associated with skin or respiratory infections, its occurrence in adult meningitis is extremely rare and often related to head trauma. The condition is associated with high mortality, underscoring its severity. These cases underscore the complexities of diagnosing and managing rare forms of bacterial meningitis, emphasizing the necessity of a precise diagnostic approach.