Cases Of Bacterial Meningitis Research Articles

Epidemiology and antimicrobial resistance patterns of bacterial meningitis among hospitalized patients at a tertiary care hospital in Saudi Arabia: a six-year retrospective study.

Bacterial meningitis poses significant medical challenges due to its acute inflammatory nature and potential for severe neurological complications, emphasizing the need for prompt diagnosis and treatment. Limited data exists on its epidemiology and antimicrobial resistance trends among hospitalized patients in Saudi Arabia. This study aimed to investigate these factors at a tertiary care hospital over six years. A retrospective analysis was conducted on cerebrospinal fluid samples results from 222 bacterial meningitis cases among hospitalized patients between 2018 and 2023. Demographic, clinical, microbiological data, and antibiotic susceptibility patterns were collected and analyzed. Pseudomonas aeruginosa (43%) was the predominant pathogen isolated. Neonates (16%) and children (47%) were most affected population. Nosocomial meningitis accounted for 92% of cases, mainly in the intensive care settings (50.45%). Extended-spectrum beta-lactamase was the leading resistance pattern (12.2%). Seasonal variation was observed, with a peak incidence in October-November. The study highlights the substantial burden of bacterial meningitis among hospitalized patients, especially among high-risk groups. Emerging antimicrobial resistance emphasizes the need for optimized surveillance and stewardship. Future prospective research employing molecular techniques across multiple centers in the country is warranted to enhance understanding and guide public health strategies in Saudi Arabia.

Bacterial Meningitis Caused by Streptococcus Suis, Complicated by Secondary Ventriculoperitoneal Shunt-Associated Peritonitis: A Rare Clinical Case Presentation

The main method of treating hydrocephalus is through liquor shunt surgery, with preference given to Ventriculoperitoneal Shunts (VPS). However, as the number of implanted bypass systems in the abdominal cavity increases, so does the number of complications, both intraventricular and abdominal. We present a unique case of primary bacterial meningitis caused by Streptococcus suis, which was complicated by secondary shunt-associated diffuse fibrinous peritonitis in a 28-year-old female patient.

STUDY OF ACUTE BACTERIAL MENINGITIS IN CHILDREN BY GRAM STAIN, CULTURE AND ANTIGEN DETECTION

Objective: Acute Bacterial Meningitis (ABM) is associated with a high mortality rate and morbidity in paediatric population despite recent advances in diagnostic methods, antimicrobial and supportive treatments and monitoring. This study is therefore undertaken to aid in rapid diagnosis of ABM by latex agglutination test (LAT) and to comparatively evaluate Gram stain, Culture and LAT in the diagnosis of ABM along with antibiotic susceptibility pattern of the isolates. We undertake this study in children with symptoms of meningitis to isolate and identify the pathogens in CSF and blood and to determine their antibiotic susceptibility pattern. We will compare and evaluate the three methods Gram stain, culture and Antigen detection.
 Methods: A hospital-based prospective study conducted at Government General Hospital, Kakinada during December 2018–August 2020. A total of 50 clinically suspected cases of bacterial meningitis in the paediatric age group were taken. The CSF sample was collected and subjected to Gram stain, culture and antigen detection tests using PASTOREX TMMENINGITIS kit.
 Results: Out of 50 samples collected, 15 cases were declared as laboratory confirmed cases as per WHO criteria. Gram stain was positive in 6 cases. CSF culture could identify 8 cases of ABM. CSF LAT was positive in 12 cases. Group B Streptococcus was the most common etiological agent in neonates, while S. pneumoniae in children. The isolates were 100% sensitive to cefoperazone, cefuroxime, cefepime and gentamicin.
 Conclusion: Although Gram stain is simple and CSF culture is the gold standard, LAT has an advantage over Gram stain in terms of species identification. It was found to be more sensitive, rapid, easy to perform and could identify fastidious organisms like S. pneumoniae, N. meningitidis and Group B Streptococcus.

Surveillance of Bacterial Meningitis in the Italian Hospital of Desio: A Twenty-Year Retrospective Study

Bacterial meningitis is a severe infection with a high fatality rate, and affects children in particular. Three vaccines against the most common bacterial causatives of meningitis, Haemophilus influenzae type b, Streptococcus pneumoniae, and Neisseria meningitides, exist. Monitoring the type and incidence of bacterial meningitis is important for making future prevention and control plans. In this study, we retrospectively analyzed data regarding bacterial meningitis recovered in the Italian Hospital of Desio from 2000 to 2019. Samples from a total of 128 patients were included. Streptococcus pneumoniae was the most common microorganism, isolated in 45 cases, followed by Neisseria meningitidis (14), Listeria monocytogenes (8), Streptococcus agalactiae (group B) (4), and Haemophilus influenzae type b (2). The implementation of vaccination schedules decreased the number of bacterial meningitis cases caused by H. influenzae type b, S. pneumoniae, and N. meningitidis. Considering the bacterial meningitis cases in subjects aged 0–12 years, no H. influenzae type b strain was isolated, five cases of N. meningitidis were identified before the introduction of vaccination, and seven S. pneumoniae strains were isolated before the introduction of the PCV13 vaccination. Surveillance studies allowed us to monitor changes in bacteria distribution and to guide vaccination strategies.

A Case of Bacterial Meningitis in Which Occurrence of Ataxie Optique Led to Detection of a Small Subdural Abscess and Pialitis

We report the case of a 69-year-old man with bacterial meningitis who presented with ataxie optique in the peripheral part of the left visual field in both hands. A detailed neurological examination with contrast-enhanced brain MRI in the early stage of the clinical course identified a small subdural abscess and pialitis in the right parietal area. A favorable outcome was obtained with antibiotic therapy alone. In a case with higher brain dysfunction of unknown cause in the clinical course of bacterial meningitis, a detailed neurological examination may be helpful to identify the causative site. (Received September 25, 2023; Accepted October 31, 2023; Published March 1, 2024).

A Reduction in the Number of Hospitalized Cases of Acute Meningitis during the COVID-19 Pandemic in Japan.

Objective The changes in the prevalence of acute meningitis during the coronavirus disease 2019 (COVID-19) pandemic remain unclear. This study aimed to compare the prevalence of acute meningitis before and during the COVID-19 pandemic in Japan. Methods We retrospectively reviewed the Japanese nationwide administrative medical payment system database, Diagnosis Procedure Combination (DPC), from 2016 to 2022. A total of 547 hospitals consistently and seamlessly offered DPC data during this period. The study period was divided into the following three periods: April 2016 to March 2018 (fiscal years 2016-2017), April 2018-March 2020 (2018-2019), and April 2020-March 2022 (2020-2021). Results Among the 28,161,806 patients hospitalized during the study period, 28,399 were hospitalized for acute meningitis: 16,678 for viral/aseptic type, 6,189 for bacterial type, 655 for fungal type, 429 for tuberculous, 2,310 for carcinomatous type, and 2,138 for other or unknown types of meningitis. A significant decrease during the pandemic was confirmed in viral (n=7,032, n=5,775, and n=3,871 in each period; p<0.0001) and bacterial meningitis (n=2,291, n=2,239, and n=1,659; p<0.0001) cases. Meanwhile, no decrease was observed in fungal meningitis (n=212, n=246, and n=197; p=0.056) or carcinomatous meningitis (n=781, n=795, and n=734; p=0.27). The decrease in the number of tuberculous meningitis cases was equivocal (n=166, n=146, and n=117; p=0.014). The decrease during the pandemic was more remarkable in younger populations aged <50 years than in older populations, both for viral and bacterial meningitis. Conclusion The number of hospitalized cases of acute meningitis clearly decreased during the COVID-19 pandemic, especially for viral and bacterial meningitis in younger populations aged <50 years.

A Case Report on Bacterial Meningitis and its Management

An elderly female patient was admitted to a critical care unit due to headache and vomiting. She was eventually found to have bacterial meningitis. An inflammation of the meninges around the brain and spinal cord is called bacterial meningitis. Covering the dura mater, arachnoid mater, and pia mater, the study underlines the criticality of diagnosing and treating bacterial meningitis as soon as possible because of its potentially lethal nature. A life-threatening inflammation of the meninges can result from various pathogens, with Streptococcus pneumoniae being a predominant cause. The first stages of management involve early detection, diagnostic testing, and prompt antibiotic treatment. Empirical therapy, such as a combination of ceftriaxone and vancomycin, is crucial. Corticosteroids, particularly dexamethasone, can be administered to reduce cerebral edema and intracranial pressure. The report emphasizes the importance of timely intervention in bacterial meningitis cases to improve outcomes and prevent complications.

Epidemiological Profile of Communicable Diseases in Childhood within the Babylon Governorate, Iraq from 2017 to 2021

Background: Notifiable communicable diseases are a significant public health issue in Iraq, particularly among children. Aims: This study aimed to comprehensively assess the epidemiological profile of childhood communicable diseases in Babylon Governorate, Iraq, over the period 2017–2021 Methods and Material: Data from 11,925 cases of notifiable communicable diseases were collected from the health department in AL-Hilla City, Iraq, between 2017 and 2021. The data were analysed according to the mode of transmission, type of infection, and age and sex patterns. Results: The majority of the reported communicable diseases (85.4%) were droplet and airborne infections, with pneumonia being the most frequently reported respiratory infection (76.8%). The reported cases of pertussis, viral meningitis, bacterial meningitis, chickenpox, and mumps showed a significant decrease during the study period, while the incidence of measles had two peaks in 2019 and 2020. Viral hepatitis A and typhoid fever were the most frequently reported foodborne infections. Kala-azar was the most common arthropod-borne infection, while brucellosis and rabies were the most common zoonotic infections. Pneumonia and meningitis affected infants and children aged 1-4 years more commonly than other age groups, while pertussis affected infants and children aged 1-4 years more frequently than other age groups, with a female predominance. Measles affected infants and children aged 1-4 years more commonly than older age groups, with a male predominance. Conclusions: This study provides a comprehensive overview of the occurrence and trends of notifiable communicable diseases among children in AL-Hilla City, Iraq, between 2017 and 2021. The findings highlight the need for improved surveillance and prevention measures.

Transcranial Doppler ultrasonography in bacterial meningitis: A systematic review.

Bacterial meningitis remains a global threat due to its high mortality. It is estimated that >1.2 million cases of bacterial meningitis are reported annually. Intracranial vasculopathy is an important, under-documented complication, easily detected by transcranial Doppler (TCD) ultrasonography. Following the PRISMA Guidelines, we reviewed the utility of TCD in bacterial meningitis. This is a systematic review of observational studies on the use of TCD in patients with CSF-proven bacterial meningitis. Characteristic changes in TCD parameters along the course of the disease, correlation of TCD findings with neuroimaging, and functional outcomes were evaluated. Nine studies were included with a total of 492 participants (mean age of 42). The most common TCD finding was intracranial arterial stenosis of the MCA (50%-82%) and ischemia (33%) was the predominant neuroimaging finding. The presence of an abnormal TCD finding increased the risk of poor outcomes as high as 70%. Patients diagnosed with bacterial meningitis who underwent TCD show alterations in cerebral blood flow, correlating with imaging findings and poor outcomes. It aids in the diagnosis of its sequelae and can predict the prognosis of its outcome. TCD is a cost-effective, reliable modality for diagnosing vasculopathy associated with bacterial meningitis. It may prove useful in our armamentarium of management. Large prospective studies with long-term follow-up data may help establish the use of TCD in bacterial meningitis.

Development of VRE meningitis due to haematogenous spread while on high-dose daptomycin therapy.

Vancomycin-resistant Enterococcus faecium (VRE) meningitis accounts for only 0.3%-4.0% of bacterial meningitis cases and typically occurs following neurosurgical intervention. We describe a rare case of a patient without neurological devices in situ or a recent neurological procedure who developed VRE meningitis via haematogenous spread. Optimal treatment for VRE meningitis is unknown. A 67-year-old male with end-stage liver failure underwent liver transplantation complicated by VRE bacteraemia and subsequently developed VRE meningitis while on high-dose daptomycin therapy (12 mg/kg/day). Due to clinical and microbiological failure with daptomycin, he was switched to linezolid and symptoms resolved rapidly. He completed 2 weeks of linezolid, fully recovered, and continued to do well without complications at the 5 month follow-up. This case highlights the severity of VRE infections in solid organ transplant recipients and raises concerns about daptomycin penetration into the CNS. Linezolid could be considered the preferred treatment for VRE CNS infections rather than high-dose daptomycin.

Bacterial coinfection in young febrile infants with SARS-CoV-2 infection.

We aimed to assess the prevalence of serious bacterial infections (SBIs) in febrile infants < 90days of age with SARS-CoV-2 infection versus SARS-CoV-2-negative febrile infants.A retrospective cohort study was conducted in a tertiary pediatric emergency department between March 2020 and October 2022. Febrile infants < 90days of age who underwent SARS-CoV-2 testing were included. SBIs were defined as urinary tract infection (UTI), bacteremia, and/or bacterial meningitis; bacteremia and bacterial meningitis were considered invasive bacterial infections (IBIs). SBIs rates were compared between SARS-CoV-2-positive and negative infants and stratified by age.We included 779 infants: 221 (28.4%) SARS-CoV-2-positive and 558 (71.6%) SARS-CoV-2-negative. The SBI rate in the SARS-CoV-2-positive group was 5.9% vs 22.9% in the SARS-CoV-2-negative group (p < 0.001; relative risk (RR) 0.26; [95% CI 0.15-0.44]); the most common infections were UTI (5.4% vs 22.0%; p < 0.001). The IBI rate was 0.5% in the SARS-CoV-2-positive group vs. 3.2% in the negative group (p = 0.024; RR 0.14 [95% CI 0.02-1.04]). There were no cases of bacterial meningitis in the positive infants. SARS-CoV-2-positive infants > 28days of age had a decreased likelihood of SBI (RR 0.22 [95% CI 0.11-0.43]), with no cases of IBI identified. Conclusions: Febrile infants < 90days of age with SARS-CoV-2 infection are at significantly lower risk of SBIs than those who are SARS-CoV-2-negative. Nevertheless, the rate of UTI remains considerable in SARS-CoV-2-positive infants. SARS-CoV-2 detection may be relevant in considering IBI risk for well-appearing febrile infants 29-89days of age. What is Known: • Febrile infants with laboratory-confirmed viral infections have a significantly lower risk of serious bacterial infections when compared to those without them. Data focusing on very young febrile infants with a SARS-CoV-2 infection is still limited. What is New: • Young febrile infants with SARS-CoV-2 infection are at significantly lower risk of serious bacterial infections than those who are SARS-CoV-2-negative. Nevertheless, the rate of urinary tract infection remains considerable. SARS-CoV-2 detection may be relevant in considering invasive bacterial infection risk for well-appearing febrile infants 29-89days of age.

Disease Burden of Meningitis Caused by Streptococcus pneumoniae Among Under-Fives in China: A Systematic Review and Meta-analysis.

Streptococcus pneumoniae is the leading cause of meningitis, with a case fatality of up to about 50%. Children younger than 5 years are at greater risk for pneumococcal meningitis compared with other populations. It is of significant importance to provide a comprehensive understanding of the burden of pneumococcal meningitis among under-fives in the low pneumococcal conjugate vaccine (PCV) coverage period in China. A systematic review was conducted. We searched both English (PubMed, Ovid-EMBASE, Biosis, Web of Science, and Cochrane) and Chinese (CNKI, Wanfang, and ViP) databases for studies on bacterial meningitis in China published between January 1980 and July 2022. Ineligible studies were excluded based on study design and data integrity. Heterogeneity was assessed with I2 and estimates of bacterial meningitis morbidity and mortality were pooled using random-effects models. Subgroup analysis was conducted to trace the source of the heterogeneity and summarize average estimates. A total of 13,082 studies were identified in the literature, and 56 studies were finally included for data analysis. The estimated incidence of pneumococcal meningitis was 2.10 cases per 100,000 children younger than 5 years each year (95% CI: 0.59-7.46), with a pooled case fatality rate of 24.59% (95%CI: 19.35-30.28%) in China. It was estimated that 1617.16 (95% CI: 454.35-5744.78) pneumococcal meningitis cases and 548.86 (95% CI: 474.80-627.62) deaths occurred among under-fives in China in 2020. Streptococcus pneumoniae played an important role in the etiology of confirmed bacterial meningitis cases, with a pooled proportion of 22.05% (95% CI: 17.83-26.27%). The most prevalent serotypes were 6B, 14, 19F, 19A, and 23F, which were preventable with a vaccine. Pneumococcal meningitis remains one of the most important health problems among children younger than 5 years in China. Immunization programs should be promoted to avoid preventable cases and deaths.

Predictive signs and symptoms of bacterial meningitis isolates in Northern Ghana

Cerebrospinal meningitis (CSM) is a public health burden in Ghana that causes up to 10% mortality in confirmed cases annually. About 20% of those who survive the infection suffer permanent sequelae. The study sought to understand the predictive signs and symptoms of bacterial meningitis implicated in its outcomes. Retrospective data from the Public Health Division, Ghana Health Service on bacterial meningitis from 2015 to 2019 was used for this study. A pre-tested data extraction form was used to collect patients’ information from case-based forms kept at the Disease Control Unit from 2015 to 2019. Data were transcribed from the case-based forms into a pre-designed Microsoft Excel template. The data was cleaned and imported into SPSS version 26 for analysis. Between 2015 and 2019, a total of 2446 suspected bacterial meningitis cases were included in the study. Out of these, 842 (34.4%) were confirmed. Among the confirmed cases, males constituted majority with 55.3% of the cases. Children below 14 years of age were most affected (51.4%). The pathogens commonly responsible for bacterial meningitis were Neisseria meningitidis (43.7%) and Streptococcus pneumoniae (53.0%) with their respective strains Nm W135 (36.7%), Nm X (5.1%), Spn St. 1 (26.2%), and Spn St. 12F/12A/12B/44/4 (5.3%) accounting for more than 70.0% of the confirmed cases. The presence of neck stiffness (AOR = 1.244; C.I 1.026–1.508), convulsion (AOR = 1.338; C.I 1.083–1.652), altered consciousness (AOR = 1.516; C.I 1.225–1.876), and abdominal pains (AOR = 1.404; C.I 1.011–1.949) or any of these signs and symptoms poses a higher risk for testing positive for bacterial meningitis adjusting for age. Patients presenting one and/or more of these signs and symptoms (neck stiffness, convulsion, altered consciousness, and abdominal pain) have a higher risk of testing positive for bacterial meningitis after statistically adjusting for age.

Mathematical model for the dynamics of bacterial meningitis (Meningococcal meningitis): a case study of Yobe State Specialist Hospital, Damaturu, Nigeria

A model for bacterial meningitis was created by adding a class of transporters to the basic Susceptible Carrier Infected and Recovered (SCIR) model, since vaccination and treatment are the best methods of controlling the transmission of most overpowering sicknesses. Immunization assists helpless people with building either a drawn out invulnerability or transient resistance while treatment decreases the quantity of sickness actuated passing and the quantity of irresistible people locally or country. This study comprises of a mathematical model for bacterial meningitis dynamics that can be used to a wide range of mathematical modeling problems. In this exploration, a nonlinear deterministic model with time reliance controls has been proposed to depict the elements of bacterial meningitis in a populace. We discovered that the (EEP) and (DFE) are locally asymptotically stable in our study. We now advise the researcher to determine whether it is globally asymptotically stable in order to achieve optimal disease control. The presence of an endemic harmony and the calculation of the reproduction number . The mathematical arrangement shows that vaccinating vulnerable people will prompt disposal of the infection in the public and furthermore it will lessen the weight on wellbeing suppliers. Numerical simulations were presented to explain the parameters in the end path in the model were carried out by using MAPLE software. Most likeable of this research work shows that the rate at which treatment and vaccination rate increases to the higher value the recovered compartment increases to the peak point. This means treatment and vaccination has an impact on reducing the case of bacterial meningitis in a population. Now we conclude that a high infection transmission rate requires a high vaccine and treatment rate on the effect of vaccination against meningitis.

Recurrent Bacterial Meningitis due to Osteomyelitis of the Odontoid Process

Recurrent meningitis is defined as more than one episode of meningitis that is separated by an entire recovery period. Causes of recurrent meningitis include anatomical defects, immune deficiency, and parameningeal infections. A thorough investigation of the underlying causes of recurrent meningitis is required for proper treatment. Herein we report a case of recurrent bacterial meningitis caused by osteomyelitis of the odontoid process.

A Pediatric Case of Bacterial Meningitis by Acute Isolated Sphenoid Sinusitis

A Pediatric Case of Bacterial Meningitis by Acute Isolated Sphenoid Sinusitis

A Case of Bacterial Meningitis Caused by Bacillus subtilis var. natto.

A 67-year-old woman with a 2-day history of a fever, headache and disturbed consciousness was admitted to our hospital. Bacillus subtilis was isolated from both the cerebrospinal fluid and blood. She was cured by the administration of vancomycin. Next-generation sequencing identified the strain as B. subtilis var. natto, the same strain found in natto, which this patient ate daily. We suspected that some of the B. subtilis that caused the infection may have actually been B. subtilis var. natto.

The Cost of Suspected and Confirmed Bacterial Meningitis Cases in Jimma University Specialized Hospital in Southwest Ethiopia.

The Cost of Suspected and Confirmed Bacterial Meningitis Cases in Jimma University Specialized Hospital in Southwest Ethiopia.

Childhood Bacterial Meningitis Surveillance in Southern Vietnam: Trends and Vaccination Implications From 2012 to 2021.

This retrospective hospital-based surveillance aimed to assess the epidemiology, causative pathogens trend, and serotypes distribution of pneumococcal meningitis among children aged under 5 years with bacterial meningitis in Southern Vietnam after the introduction of pentavalent vaccine in the Expanded Program on Immunization (EPI). From 2012 to 2021, cerebrospinal fluid samples were collected from children aged under 5 years with suspected bacterial meningitis at Children's Hospitals 1 and 2 in Ho Chi Minh City. Probable bacterial meningitis (PBM) cases were identified using biochemistry and cytology. Real-time polymerase chain reaction was used to confirm cases of confirmed bacterial meningitis (CBM) caused by Streptococcus pneumoniae, Haemophilus influenzae, or Neisseria meningitidis. Streptococcus pneumoniae serotyping was performed. Of the 2560 PBM cases, 158 (6.2%) were laboratory-confirmed. The CBM proportion decreased during the 10-year study and was associated with age, seasonality, and permanent residence. Streptococcus pneumoniae was the most common pathogen causing bacterial meningitis (86.1%), followed by H influenzae (7.6%) and N meningitidis (6.3%). The case-fatality rate was 8.2% (95% confidence interval, 4.2%-12.2%). Pneumococcal serotypes 6A/B, 19F, 14, and 23F were the most prevalent, and the proportion of pneumococcal meningitis cases caused by the 10-valent pneumococcal conjugate vaccine (PCV) serotypes decreased from 96.2% to 57.1% during the PCV eras. Streptococcus pneumoniae is the most frequent causative agent of bacterial meningitis in children aged under 5 years in Southern Vietnam over the last decade. Policymakers may need to consider introducing PCVs into the EPI to effectively prevent and control bacterial meningitis.

Bacterial Meningitis, Streptococcus Suis Isolate: A Case Series (P1-10.007)

<h3>Objective:</h3> NA <h3>Background:</h3> Streptococcus Suis is an avoidable infection in humans with exposure/contact of contaminated pigs/pig products causing meningitis and septicemia; loss of hearing is a more frequent complication (Gill, C.O. et al). We present here 2 cases of bacterial meningitis from streptococcus suis infection. A 57-year old male with fever, biparieto-occipital headache, non-rotatory dizziness, vomiting, left ear hearing loss, and decreasing sensorium. He recently ate at a local Samgyupsal place. He was febrile, drowsy, disoriented, had left ear sensorineural hearing loss, and signs of meningeal irritation. On brain MRI, splenium restricted diffusion with bilateral frontal flair hyperintensity without enhancement seen. Blood culture showed streptococcus suis. Cerebrospinal fluid (CSF) was turbid, leukocyte 60 cells/uL, elevated protein and glucose, other CSF studies were unremarkable. He was started on Penicilin G and steroid therapy. A 51-year old female with fever, bi-parietal headache, non-rotatory dizziness, vomiting, hearing loss, and signs of meningeal irritation. She recently ate at a local Samgyupsal place. She was febrile, awake, had right ear sensorineural hearing loss, and signs of meningeal irritation. On brain MRI, there was bilateral cerebral sulci and cerebellar interfoliar spaces diffuse flair hyperintensities with ventral brainstem and leptomeningeal enhancement. CSF was clear with leukocyte 16 cells/uL, elevated protein, and low glucose. Blood and CSF culture showed streptococcus suis; other CSF studies were unremarkable. The patient was started on Penicilin G and steroid therapy. <h3>Design/Methods:</h3> NA <h3>Results:</h3> NA <h3>Conclusions:</h3> Streptococcus suis in humans is acquired from occupational or household exposure to contaminated pigs/pig meat (Huang, Y.T. et al). It is recognized that suboptimal pork preparation/consumption may increase the risk of acquiring this disease, as our cases above. The treatment principles in bacterial meningitis are mostly the same regardless of the isolate. The treatment with steroids is still controversial however there are studies that show improvement in the patient’s hearing and dizziness. <b>Disclosure:</b> Ms. Abbot has nothing to disclose. Dr. Ng has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Unilab. Dr. Ng has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Menarini. Dr. Ng has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Torrent Pharma. Samantha Anne Gutierrez has nothing to disclose.