A Rare Case of Meningitis Caused by Elizabethkingia meningoseptica in a Baby at the Buea Regional Hospital, South West Region, Cameroon

Abstract

Aim: This report was aimed at determining the possible source, risk factors, antimicrobial susceptibility pattern and clinical management of the first recorded case of meningitis in Cameroon caused by Elizabethkingia meningoseptica. Presentation of case: A 10 months old baby previously diagnosed with otitis media was admitted at the Buea regional hospital on the 21st of October 2023 after a referral following unsuccessful treatment.  Upon admission, the baby had persistent fever, catarrh (evidence of an upper respiratory tract infection) and abdominal discomfort. Patient developed decreased body movement, altered consciousness and neck stiffness even after being placed on ampicillin and cefotaxime for two days. Based on cerebrospinal fluid analysis, the patient was considered a probable meningitis case and put on ceftriaxone to no avail. CSF culture later revealed the presence of Elizabethkingia meningoseptica susceptible to ciprofloxacin and resistant to imipenem, amoxicillin-clavulanic acid, cotrimoxazole, ampicillin and ceftriaxone.  Marked improvement was noticed and the patient was discharged following full recovery after treatment with ciprofloxacin for 21 days. Epidemiological investigations and active case search did not provide any evidence of the Elizabethkingia being acquired in the hospital. Discussion and conclusion: The Elizabethkingia in this case was most likely community acquired associated with acute otitis media probably linked to a recent upper respiratory tract infection. The isolate was resistant to ceftriaxone and susceptible to ciprofloxacin. In case of meningitis caused by this pathogen, empirical treatment with fluoroquinolones may most likely be an effective option in the absence of antimicrobial susceptibility testing.