AN UNUSUAL case of mycobacterial meningitis caused by Mycobacterium bovis is reported. Sparse growth of the initial isolate, obtained from the CSF, raised the possibility of M bovis or resistant M tuberculosis infection. Enhanced growth on a glycerol-free medium and results of biochemical testing led to the identification of M bovis.
Report of a Case
A 63-year-old male dentist was admitted to a community hospital on Aug 20, 1980, after ten days of headache, stiff neck, and photophobia. He was confused, but there were no focal neurological findings. Cerebrospinal fluid analysis disclosed 290 WBCs per cubic millimeter, with 90% lymphocytes and 10% neutrophils. The CSF protein level was 193 mg/dL and the glucose level was 22 mg/dL, with a serum glucose level of 105 mg/dL. He did not respond to administration of intravenous penicillin G potassium, 24 million units/ day, became more confused, and was transferred to the University of
Jones PG, Silva J. Mycobacterium bovis Meningitis. JAMA. 1982;247(16):2270–2271. doi:10.1001/jama.1982.03320410052032