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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