Campylobacter fetus meningoencephalitis: a case report

INTRODUCTION: Campylobacter(C) fetus meningoencephalitis is rare and occurs mainly in elderly and immunocompromised patients. We report an observation of C. fetus meningoencephalitis in a woman with a favorable evolution. CASE REPORT: A 54-year-old woman with systemic lupus erythematosus was treated with mycophenolate mofetil (MMF) and corticosteroids. The patient presented at the emergency department of Sahloul University Hospital with a fever and headache for 24 hours. She had regular contact with sheep and cattle. She reported a penicillin allergy. On admission, she had a temperature of 39°C and she was confused. Brain CT scan was normal. Lumbar puncture showed a clear cerebrospinal fluid (CSF) with 1300 leukocytes/mm3 (65% lymphocytes) and low glucose levels. CSF microscopic examination was negative. She was treated with vancomycin, cotrimoxazole, and gentamicin with an improvement of the neurological symptoms and apyrexia. The next day, she had a neurological deterioration. Brain angio-magnetic resonance imaging was normal. The culture of the CSF became positive for C. fetus. Our patient was treated with imipenem combined with ciprofloxacin and obtained clinical and biological improvements. CONCLUSIONS: C. fetus is a rare cause of bacterial meningoencephalitis. The underlying immunodepression should always be considered.