Abstract

BackgroundBacterial meningitis is a life-threatening disease associated with high morbidity and mortality. Subarachnoid hemorrhage (SAH) can accompany bacterial meningitis in adult patients in <1% of cases and significantly worsens the patient’s prognosis.Case reportA 58-year-old man presented to the emergency department complaining of a 5-day history of progressive abdominal pain, when he suddenly developed “the worst headache of his life” and suffered a 4-minute seizure. Computed tomography head showed SAH. An emergent cerebral angiogram was negative for any bleeding source, and attention shifted to meningoencephalitis. Ultimately, the patient was found to have Group B Streptococcus (GBS) meningitis on cerebrospinal fluid polymerase chain reaction.ConclusionTo the best of our knowledge, this patient’s presentation of GBS meningitis, masked by a classic aneurysmal SAH presentation, represents a rare and acute presentation of an underlying disease complication. Increasing awareness of this presentation can support more rapid diagnosis, earlier treatment, and improved outcomes for affected patients.

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