BMJ Case Reports 2011; doi:10.1136/bcr.02.2011.3830
  • Rare disease

How a bowel tumour led to meningitis

  1. Varun Nelatur2
  1. 1Department of Geriatrics, Oxford Radcliffe Trust, Slough, UK
  2. 2Department of Acute Medicine, Oxford Radcliffe Trust, Oxford, UK
  1. Correspondence to Dr Toby Edward Shipway, toby.shipway{at}


This report summarises a case history in which a 75-year-old man was admitted with bacterial meningitis caused by Streptococcus bovis. A subsequent abdominal investigation in the light of the known association between invasive S bovis infection and colonic cancer confirmed the suspicion of a cancer located to the rectum. The patient died from Clostridium difficile enterocolitis with sepsis and multi-organ failure. This is a highly relevant and interesting case presentation, which besides providing a learning point that patients with S bovis infection should undergo investigation for abdominal cancer, describes a ‘best practice’ pattern in which clinicians followed up on a known association between a rare clinical presentation and underlying disease.


  • Competing interests None.

  • Patient consent Obtained.

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