Mania: An atypical presentation of probable Streptococcus agalactiae meningoencephalitis
Ann Hudson,
Daniel Bobo,
Libardo Rueda Prada,
Igor Dumic,
Emilia Petcu,
Milena Cardozo,
Fnu Shweta
Affiliations
Ann Hudson
Mayo Clinic Alix School of Medicine, Rochester, MN, USA; Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI, USA
Daniel Bobo
Mayo Clinic Alix School of Medicine, Rochester, MN, USA; Department of Family Medicine, Mayo Clinic Health System, Eau Claire, WI, USA
Libardo Rueda Prada
Mayo Clinic Alix School of Medicine, Rochester, MN, USA; Hospital Medicine, Mayo Clinic, Jacksonville, FL, USA
Igor Dumic
Mayo Clinic Alix School of Medicine, Rochester, MN, USA; Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI, USA
Emilia Petcu
Mayo Clinic Alix School of Medicine, Rochester, MN, USA; Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI, USA
Milena Cardozo
Mayo Clinic Alix School of Medicine, Rochester, MN, USA; Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI, USA; Corresponding author at: Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI, USA.
Fnu Shweta
Mayo Clinic Alix School of Medicine, Rochester, MN, USA; Department of Infectious Diseases, Mayo Clinic Health System, Eau Claire, WI, USA
Streptococcus agalactiae, also known as Group B Streptococcus (GBS), is a common pathogen in the neonatal period, causing meningitis and sepsis. In non-pregnant adults it is an unusual cause of meningitis. We report about an elderly female with several risk factors for invasive GBS infection who developed GBS meningoencephalitis one month after treatment for COVID-19 upper respiratory tract infection. The patient presented with mania, and the classic triad of headache, neck stiffness, and fever was absent which contributed to the delay in diagnosis. Following initiation of treatment with intravenous ceftriaxone she attained full recovery, and her behavior returned to baseline. This case illustrates an unusual presentation of an emerging infection and should alert clinicians about this presentation. By reporting this case we want to raise awareness about mania as a presenting feature of meningoencephalitis. This should lead to more timely diagnosis and better outcomes for future patients.