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Adynamic ileus as an atypical manifestation of Staphylococcus aureus meningitis confirmed by metagenomic next-generation sequencing: A case report

Year: 2025

Type: article

Abstract: Staphylococcus aureus is an uncommon cause of bacterial meningitis, and S. aureus meningitis complicated with adynamic ileus has not been previously documented. This report presents a rare case of a man in his late 30s who developed purulent meningitis and intestinal pseudo-obstruction secondary to a skin-derived S. aureus infection. The patient initially presented with persistent fever, headache, and altered mental status. Subsequently, he developed abdominal distention, vomiting, dysuria, and meningeal signs. Laboratory tests revealed hyponatremia and elevated cerebrospinal fluid pressure; however, conventional cerebrospinal fluid culture failed to detect any pathogen. Diagnosis was ultimately confirmed through metagenomic next-generation sequencing, which identified S. aureus as the causative agent. Targeted antimicrobial therapy with vancomycin and meropenem resulted in rapid clinical improvement. This case highlights the importance of considering central nervous system infections in patients presenting with unexplained gastrointestinal and autonomic symptoms. Moreover, it emphasizes the clinical utility of metagenomic next-generation sequencing in identifying pathogens in culture-negative, atypical infections. Early recognition and intervention are essential to improving outcomes in such complex presentations.

Source: Journal of International Medical Research

DOI: 10.1177/03000605251365895

Authors: Tonger Liang, Junjie Situ, Hanqiao Qin, Jia Peng

Institutions: Third People's Hospital of Chengdu, Southwest Jiaotong University, Southwest Medical University, Affiliated Hospital of Southwest Medical University, Chengdu University of Traditional Chinese Medicine

Language: English

Topic: Bacterial Infections and Vaccines

Subfield: Microbiology

Field: Immunology and Microbiology

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $4,155