• Rola A Cheaito, Ghassan Awar, Maria Alkozah, Mohamad Ali Cheaito, and Imad El Majzoub.
• Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon. Electronic address: rc65@aub.edu.lb.
• Am J Emerg Med. 2020 Jun 1; 38 (6): 1298.e1-1298.e3.

AbstractBacterial meningitis is a life-threatening condition that should be addressed as an emergency. The typical culprit microorganisms are targeted empirically with ceftriaxone and vancomycin, in the absence of an immunocompromised state. In this case report, however, we are describing a case of meningitis secondary to Weissella confusa, bacteria inherently resistant to the two drugs commonly used to empirically treat meningitis. Weissella spp. are Gram-positive, catalase-negative coccobacilli and an infrequent cause of infection in humans. Bacteremia followed by endocarditis are the typical clinical manifestations of W. confusa in humans. Other reported manifestations include post-operative osteomyelitis, thumb abscess, infected prosthetic joint, infected peritoneal fluid and peritonitis. To our knowledge, this is the first case of meningitis due to Weissella confusa in the literature. Therefore, we conclude that the isolation of Gram-positive coccobacilli resistant to vancomycin, especially in an immunocompromised host, should raise the suspicion of W. confusa.Copyright © 2020 Elsevier Inc. All rights reserved.

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