Unprovoked adult-onset E.Coli meningitis in absence of common risk factors: A rare case report

E. coli meningitis is a rare diagnosis in adults and is mostly seen in neonates or in individuals with risk factors like immunosuppression, neurosurgical procedures, head trauma, or systemic infections. In this case, we present a 28-year-old female with no known comorbidities or predisposing conditions who developed E. coli meningitis, making it an exceptionally rare occurrence. She initially presented with high-grade fever and altered sensorium, and CSF analysis later confirmed E. coli as the causative organism. Blood and urine cultures also came back positive for E. coli, pointing toward systemic involvement. The bacteria was resistant to most antibiotics and only sensitive to colistin, which was started promptly. Despite ICU care, targeted antibiotic therapy, and all supportive measures, the patient’s condition deteriorated following a seizure, and she eventually suffered cardiopulmonary arrest. This case highlights how E. coli meningitis can present even in completely healthy adults without any obvious source, underlining the importance of timely CSF analysis and culture to guide management. Categories: Internal Medicine, Infectious Disease.