Abstract
The first documented instance of acute bacterial meningitis caused by Streptococcus suis in Colombia has been reported. A 69-year-old male resident of a rural area with a history of direct contact with pigs presented to the clinic with a persistent fever, severe headaches, and altered consciousness. Cerebrospinal fluid analysis showed neutrophilic pleocytosis, increased cerebrospinal fluid protein levels, and decreased glucose due to consumption. Initial culture and confirmation by mass spectrometry MALDI-TOF identified S. suis, with an MLSB resistance profile and resistance to tetracyclines, but with sensitivity to beta-lactams, quinolones, and vancomycin. The patient received empirical treatment with ceftriaxone, vancomycin, and ampicillin, with favorable progress from the first 24 h, completing 10 days of guided therapy, restricted to ceftriaxone given the susceptibility profile on the antibiogram and its bioavailability in the central nervous system without immediate sequelae. This finding represents direct evidence of the presence of S. suis in humans in the country, raising the possibility of underdiagnosis associated with a lack of clinical suspicion and limitations in the microbiological capacity of local laboratories. The absence of classic meningeal signs in the clinical presentation underscores the necessity for a high index of suspicion, particularly in rural areas with exposure to pigs. Furthermore, the importance of considering this emerging zoonosis in the differential diagnosis of bacterial meningitis is reinforced, given its potential to cause permanent neurosensory complications. The case study outlined in this text emphasizes the pressing need to reinforce epidemiological surveillance, expand diagnostic capacity, and enhance health personnel's awareness of this zoonotic pathogen in the region. These measures are crucial for enhancing early detection and optimizing treatment outcomes.