Abstract
Streptococcus suis is a zoonotic pathogen commonly found in pigs, capable of causing disease in humans when in contact with contaminated pigs or pork products. The most common presentation in humans is meningitis, although it can also manifest as sepsis, arthritis, endocarditis, or endophthalmitis. In Europe, most cases are described as occupational disease related to pig farming or raw pork handling. We report a severe case of meningitis by S. suis in a 51-year-old man who worked as a piglet roaster. The patient presented to the emergency department in a comatose state (Glasgow Coma Scale of 7) after experiencing headache, fever and generalised myalgia. No focal or lateralizing motor signs were found on the neurological examination. The brain computed tomography scan revealed diffuse cerebral oedema and excluded other associated vascular or parenchymal lesions. Bacterial meningitis was confirmed after cerebrospinal fluid examination and empiric antibiotic therapy was started. This critically ill patient presented a rapid and fatal progression of the disease. We aim to describe a fulminant presentation of meningitis by S. suis and emphasize the importance of recognizing and promptly treating this condition, particularly in high-risk populations.