In this thesis, we describe the clinical characteristics, etiology, treatment and outcome of zoonotic bacterial meningitis.
Each chapter describes meningitis patients infected by a specific zoonotic pathogen, such as Streptococcus equi, Streptococcuis
suis, Capnocytophaga canimorsus, Campylobacter fetus and Leptospira. We combine cases identified in a nationwide prospective
cohort study of adult bacterial meningitis patients with a literature review on meningitis caused by each zoonotic pathogen.
pathogens are an uncommon cause of bacterial meningitis, but occur more frequently in individuals with specific risk factors,
such as professional contact with pigs for Streptococcuis suis meningitis, and dog bites in alcoholic men for Capnocytophaga
canimorsus meningitis. Zoonotic bacterial meningitis patients usually present with classic signs of meningitis including headache,
fever and neck stiffness. However, CSF analysis often only shows a mildly elevated CSF leukocyte count, which may lead to
confusion with viral meningitis. An immunocompromised state is associated with a worse prognosis in most pathogens causing
zoonotic meningitis. Sequelae differ per pathogen, with hearing loss being the most frequent sequel, which mainly occurs in
Streptococcus suis meningitis.
The thesis concludes with an overview of the clinical characteristics, etiology, treatment
and outcome of zoonotic bacterial meningitis. We also added a description of rare zoonotic pathogens that were not identified
in our cohort study, such as Bacillus anthracis and Francisella tularensis to the description of meningitis caused by the
formerly mentioned zoonotic pathogens.