BACTEROIDES-FRAGILIS MENINGITIS REVEALING A MENINGORECTAL FISTULA

Cases of meningitis due to Bacteroides fragilis are rare; we report a case revealing a meningorectal fistula. Case report. - A 2-month-old i nfant developed a severe sepsis syndrome following a rectosigmoidoscop y for rectal bleeding. Lumbar puncture diagnosed bacterial meningitis. Cerebrospinal fluid (CSF) culture evidenced B fragilis with betalacta mase. The initial antibiotherapy was changed for imipenem-metronidazol e, which is at present the recommended antibiotherapy. Malformation in cluding pre-spinal tumor and meningorectal fistula was evoked on magne tic resonance imaging (MRI) and confirmed by surgery. The outcome was favorable after surgery and antibiotherapy. Conclusion, - B fragilis m eningitis are usually associated with sepsis, whose origin is obvious. In our case, meningitis was isolated revealing a meningorectal fistul a. (C) 1998, Elsevier, Paris.