A 48-year-old male, with a history of excessive alcohol consumption, of rural origin.
She suffered from nausea and vomiting in the hospital where she was admitted with severe headache and fever.
Physical examination revealed meningeal signs, so she was referred to our hospital with suspected acute bacterial meningitis.
He was admitted to the emergency service in good condition, afflicted and normotensive.
Physical examination revealed right rotatory nystagmus and meningeal signs; no other pathological findings were described.
In the laboratory study, a leukocytosis of 16,850 cc was noted, with neutrophils 91.8% and a CRP of 32.12 mg/dl. Other parameters included biochemical and coagulation parameters.
A lumbar puncture was performed and a turbid elevated pressure CSF was obtained.
Cytochemical study showed a 5.6 g/l proteinorrhachia, undetectable glycorrhachia and 2,300 leukocytes/ mm3, with 95% PMN.
Gram stain was reported as Gram-positive lanceolated diplococcus.
Culture and microbiological identification methods were similar to those used in the first clinical case.
Acute bacterial meningitis was diagnosed and empirical treatment was initiated with ceftriaxone (2 g c/12 h) and dexamethasone (10 mg c/6 h) i.v.
On the second day of hospitalization, the patient developed psychomotor agitation and seizures, with little response to risperidone and haloperidol.
It was interpreted as a possible syndrome of alcohol deprivation, handled with chlordiazepoxide and thiamine.
On the sixth day of evolution the patient became asymptomatic and oriented.
S. suis serotype 2, susceptible to ceftriaxone, sensitive to ceftriaxone, penicillin G and cotrimoxazole were isolated from CSF cultures.
A control brain CT scan was performed on the sixth day of hospitalization and no pathological findings were observed.
The patient was admitted to his hospital of origin on the eighth day of clinical evolution, in good condition and without findings of neurological focalization.
He completed 14 days of treatment with ceftriaxone.
At follow-up, three months after discharge, the patient reported dizziness and bilateral hearing loss was found.
An epidemiological background ruled out that the patient created pigs.
