2026 Volume 85 Issue 2 Pages 89-93
A 90-year-old man presented with altered consciousness and neck stiffness. Cerebrospinal fluid (CSF) analysis revealed pleocytosis (9,550/μL), elevated protein (3,282 mg/dL), and decreased glucose (1 mg/dL), consistent with bacterial meningitis. The FilmArray® Meningitis/Encephalitis Panel rapidly identified Streptococcus agalactiae (group B Streptococcus: GBS) in the CSF within approximately 70 min of sample submission on the day of admission, enabling bacterial identification 19 h earlier than the blood culture results. Brain MRI performed on hospital day 11 revealed diffusion-weighted hyperintensities in the fourth ventricle, the posterior horns of both lateral ventricles, and the cerebral sulci, indicating pyogenic ventriculitis. The patient was successfully treated with penicillin G and levofloxacin for 6 weeks. Early diagnosis enables prompt de-escalation to appropriate antibiotics and favorable outcomes. This case highlights the utility of multiplex PCR panels for rapid pathogen identification in bacterial meningitis and suggests that it is particularly important in elderly patients with GBS infections who are at high risk of complications.
