Group B streptococcal meningitis associated with a CSF fistula.

An elderly man had group B streptococcal meningitis. The infection may have seeded the meninges through a rhinocerebral fistula. Despite the frequency of nasopharyngeal colonization with this organism, reports of adult meningitis secondary to group B Streptococcus are rare; to our knowledge, no previous cases specifically associated with rhinocerebral fistula have been described. Reasons for the discrepancy between the frequency of nasopharyngeal colonization and the rarity of meningitis are suggested.