Objectives: Campylobacter jejuni is one of the most common causative agents of gastroenteritis; however C. jejuni meningitis is rarely described. Therefore, little is known about its epidemiology, clinical presentation, diagnostic methods, treatment, and outcomes. Methods: In this paper, we report a case of an adult patient with C. jejuni meningitis. In addition, we reviewed 16 cases of C. jejuni published since 1980. Results: We described a 62-year-old immunocompromised patient with meningitis and gastroenteritis in whom C. jejuni was rapidly detected in cerebrospinal fluid (CSF) using 16S rDNA, while blood culture yielded the same pathogen with 48 h delay. Following 21 day-long treatment with meropenem, our patient fully recovered. Literature review revealed that C. jejuni meningitis is mainly described in newborns and adults with central nervous system comorbidities and it is most frequently detected by bacterial cultures. Conclusion: There are no clear recommendations for antimicrobial treatment of C. jejuni meningitis, but meropenem seems to be a safe and effective choice. High hopes are placed in new, broad-range culture-independent molecular methods that enable rapid pathogen detection, even in case of negative cultures.

To assess serotype distribution, antibiotic resistance, and vaccine coverage against Streptococcus pneumoniae causing invasive infections in Croatian adults from 2005 to 2019.In this retrospective study, invasive pneumococcal strains were collected through ...

Introduction: Invasive pneumococcal disease (IPD) is a severe form of illness caused by Streptococcus pneumoniae with high morbidity and mortality rate in the general population, particularly in children <5 years of age, adults ≥65 years of age and the immunocompromised. As known, pneumococcal vaccination lowers the risk of IPD so the aim of this study was to investigate whether the introduction of pneumococcal vaccination has influenced the incidence and mortality of IPD in adults in Croatia.Materials and methods: A retrospective study was conducted among adult patients (aged ≥18 years) hospitalized due to IPD in the metropolitan area of Zagreb from 1^st January 2010 to 31^st December 2022. Number of vaccine doses distributed were obtained from the healthcare system.Results: During the study period, 389 patients were hospitalized, of whom 214 (55.5%) were male. The annual incidence of IPD ranged from 0.6 to 4.1/100,000 population. A total of 185 (47.6%) patients were ≥ 65 years of age and 309 (79.4%) were ≥ 50 years of age. In 331 (85.1%) of the patients, at least one risk factor was identified, with age ≥ 65 years being the most common. Bacteremic pneumonia was the most frequent clinical presentation of IPD (66.3%). Indication for vaccination had 249 patients (64%) but only 11 patients (4.4%) were vaccinated. Also, 64 patients (16.5%) died. Serotype was determined in 233 (59.9%) of the isolates, with serotype 3 being the most frequent (49, 21%), followed by serotype 14 (38, 16.3%) and 19A (15, 6.4%). A total of 180 isolates (77.3%) were included in the 13-valent conjugate vaccine, 208 (89.3%) in the 20-valent conjugate vaccine and 212 (91%) in the 23-valent pneumococcal polysaccharide vaccine.Discussion: The introduction of pneumococcal vaccination has led to a significant decrease in the incidence and mortality of IPD in adults. To further reduce morbidity and mortality from IPD, it is necessary to increase vaccine coverage in adults, particularly in individuals with risk factors. It may be beneficial to lower the recommended vaccination age from ≥65 to ≥50 years as the substantial difference in the incidence rates of IPD between these age groups was noticed.

Background: Campylobacter jejuni is a common cause of acute gastroenteritis, but central nervous system infections are rare manifestations of Campylobacter infection. Therefore, C. jejuni trauma-related subdural hygroma infection in children is poorly described in the literature. Case presentation: We described a 2-year old boy with lobar holoprosencephaly presenting with subdural hygroma following head trauma. C. jejuni infection was confirmed from a subdural hygroma sample by culture as well as by DNA sequencing of a broad range 16S rDNA PCR product. Cerebrospinal fluid from the ventriculoperitoneal shunt remained sterile. Combined neurosurgical and antimicrobial treatment led to complete recovery. Review of the literature showed that the most common manifestation of Campylobacter central nervous system infection is meningitis, mostly in neonates, and subdural hygroma infection was described for only one case. Conclusions: Subdural hygroma infection caused by C. jejuni is a rare clinical condition in children. Molecular methods represent an important tool for the detection of rare or unexpected pathogens. No standard recommendations for antimicrobial treatment of C. jejuni subdural space infection in children are available, but meropenem treatment combined with surgery seems to be an effective approach.

We report a case of fulminant invasive meningococcal disease caused by Neisseria meningitidis serogroup Y in a young, immunocompromised adult with myasthenia gravis receiving long-term immunosuppressive therapy including ravulizumab, despite prior meningococcal vaccination. Serogroup Y is increasingly recognized in epidemiological surveillance and may be associated with atypical clinical manifestations, including the uncommon coexistence of meningitis and pulmonary involvement, as observed in this patient. The illness was characterized by rapid progression to septic shock, meningitis, and presumed pleuropneumonia. Diagnosis was confirmed by both blood PCR and culture. This case highlights the increased susceptibility to invasive meningococcal infections in individuals receiving complement-inhibiting therapy and underscores the importance of comprehensive preventive strategies, including a carefully planned and implemented vaccination schedule and careful individualized consideration of antimicrobial prophylaxis.