BMJ Case Reports 2013; doi:10.1136/bcr-2013-008592

An unusual case of E coli meningitis in a patient with Marfan's syndrome

  1. John Midturi2
  1. 1Scott & White Infectious Diseases Division, Texas A & M School of Medicine, Temple, Texas, USA
  2. 2Infectious Diseases Division, Scott & White Hospital, Temple, Texas, USA
  1. Correspondence to Dr Raghesh Varot Kangath, drraghesh.vk{at}


Spontaneous non-traumatic Escherichia coli meningitis is very rare in adults. We report a case of a 48-year-old woman with Marfan's syndrome with E coli meningitis. Apparently, the relation between an increased risk of meningitis and Marfan's syndrome is not well known. This patient was discharged on intravenous  antibiotic therapy after a diagnosis of E coli meningitis without looking for the cause by imaging studies previously. Her blood cultures were negative ruling out haematogenous spread. Our work-up revealed extensive dural ectasia with intrasacral meningoceles extending into the pelvis possibly acting as a portal of entry for the bacteria into the brain from the gastrointestinal tract.

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