Escherichia coli meningitis in a 16-month old infant revealing a posterior fossa epidermoid cyst

Meningitis due to Escherichia coli is rare, and generally observed in very particular circumstances, such as neonatal period, anatomical anomalies or in immune-deficient patients. A 16-month-old male infant was admitted for acute meningitis. E coli was detected in the cerebro-spinal fluid (CSF). As appropriate antibiotic treatment proved inefficient, a cerebral computerised tomography (CT) scan was performed, revealing an epidermoid cyst of the posterior fossa. The cyst was resected after CSF sterilisation. Postoperative recovery was satisfactory. When an unusual bacterial species such as E coli is detected in CSF, the authors suggest consideration of a cutaneous or ETN focus, or a congenital malformation with communication between cutaneous and meningeal structures.