Isolated bacterial meningitis as the key syndrome of infective endocarditis.

BACKGROUND

Bacterial meningitis is an unusual first manifestation but a major complication of infective endocarditis.

PATIENTS AND

METHODS

We present three well documented cases of isolated bacterial meningitis in endocarditis. Against this background we review the literature.

RESULTS

All patients presented with bacterial meningitis. Staphylococcus aureus was isolated in blood cultures of all patients, but was found only in the cerebrospinal fluid (CSF) of one patient. The underlying endocarditis was confirmed histologically in all three cases. Two patients recovered completely and one died.

CONCLUSION

An extensive search for endocarditis is recommended in every case of an unusual isolate in bacterial meningitis whether it is isolated from blood or CSF.