Introduction: Escherichia coli meningitis was rarely reported in adult patients. Moreover it is very rare in an adult patient without diabetes mellitus or neurosurgical shunts. In adult patients, it carries a high mortality ranging from 27% to 90% with treatment, and 100% without treatment.
Case report: We describe a 78 year old lady who presented with altered mental state and neck stiffness. Her cerebrospinal fluid analysis was consistent with bacterial meningitis and she had E. coli bacteraemia. She was treated with ceftrioxone 2 gm twice a day for 2 weeks. She also developed non-ST elevation myocardial infarction on day 3 of admission. She was treated with aspirin, low molecular weight heparin and monitored on telemetry for 3 days. She remained in hospital for 2 weeks and was discharged well.
Conclusion: E. coli meningitis carries high mortality. E. coli may cause meningitis in adult patients without diabetes mellitus or neurosurgical shunts. Early diagnosis and treatment is key to good outcome as mortality without treatment is 100%.