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

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...

Full description

Saved in:
Bibliographic Details
Main Authors: Tonger Liang, Junjie Situ, Hanqiao Qin, Jia Peng
Format: Article
Language:English
Published: SAGE Publishing 2025-08-01
Series:Journal of International Medical Research
Online Access:https://doi.org/10.1177/03000605251365895
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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.
ISSN:1473-2300