meningoencephalitis in an immunocompetent patient.

Central nervous system (CNS) infection from () is rare and usually occurs in immunosuppressed patients or in a presence of invasive CNS devices. Our case reported here is a very rare case of an immunocompetent elderly patient without any CNS devices who was diagnosed with meningoencephalitis and bacteremia. According to our patient, preceding gastrointestinal (GI) symptoms and trans-sphenoidal hypophysectomy could be the precipitating factors. A positive blood culture should not be concluded as a contamination but prompt repeating another set of blood culture for a better clinical judgment. Given its abrupt clinical course and high mortality rate, high index of suspicion for rapid detection and management is needed for a preferable clinical outcome. Empiric treatment with intravenous vancomycin is reasonable before a susceptibility result becomes available.