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May 21, 1982

Streptococcus bovis Meningitis Following a Dental Procedure

Author Affiliations

USNR National Naval Medical Center
National Institutes of Health Bethesda, Md

JAMA. 1982;247(19):2663. doi:10.1001/jama.1982.03320440015023

To the Editor.—  Streptococcus bovis, a nonenterococcal group D streptococcal species, has recently been epidemiologically associated with bacteremia and infective endocarditis in patients with neoplastic lesions of the gastrointestinal tract.1 We report a case of S bovis meningitis in a patient who had undergone mandibular nerve block for a dental procedure.

Report of a Case.—  A 55-year-old man was admitted because of severe, global headache that was abrupt in onset. One day before admission, he had undergone a right mandibular nerve block for a dental filling that produced transient anesthesia of all three divisions of the right trigeminal nerve. On examination he was afebrile, with mild nuchal rigidity. No abnormalities were noted on examination of the optic fundi, cardiovascular system, or integument. There was no induration, tenderness, or lymphadenopathy in the area of the previous nerve block. Results of stool testing using the Hemoccult slide method were negative. His