# A Rare Case of Adult Escherichia coli Meningitis Following Endoscopic Skull-Base Surgery

## TL;DR

A 65-year-old man developed rare E. coli meningitis after skull-base surgery and recovered with timely treatment.

## Contribution

Highlights a rare case of E. coli meningitis following endoscopic skull-base surgery and its successful management.

## Key findings

- E. coli meningitis occurred after endoscopic resection of a sinonasal tumor and CSF leak.
- Prompt diagnosis and treatment led to a favorable patient outcome.
- Concurrent infection with Actinomyces odontolyticus complicated the case.

## Abstract

This report describes the case of a 65-year-old male who developed Escherichia coli (E. coli) meningitis after endoscopic resection of a sinonasal neuroblastoma, complicated by a cerebrospinal fluid (CSF) leak, pneumocephalus, and subsequent concurrent infection with Actinomyces odontolyticus. The patient underwent prolonged, tailored antibiotic therapy and surgical CSF leak repair. The report highlights the importance of suspecting E. coli meningitis in post-neurosurgical patients, emphasizes the need for prompt management of CSF leaks, and underscores the need for vigilance regardless of immunocompetency. The patient fortunately survived with a favorable outcome thanks to early diagnosis, immediate intervention, and careful antibiotic management.