Volume 7,Issue 2
Tilapia Handling-Associated Streptococcus agalactiae Meningitis: A Case Series of Three Patients
The study reports three adult males (aged 47, 52, and 64 years) who presented with acute bacterial meningitis within 4 to 24 hours after sustaining tilapia-related puncture wounds. Cerebrospinal fluid (CSF) analysis consistently showed neutrophilic pleocytosis, elevated protein, and decreased glucose. All three CSF cultures yielded Streptococcus agalactiae (Group B Streptococcus, GBS) sensitive to penicillin. Blood cultures were positive in one patient. Two patients recovered completely with antibiotic therapy; the remaining patient developed post-meningitic hydrocephalus requiring ventriculoperitoneal shunting. These cases illustrate that percutaneous inoculation from fish spines can serve as a direct portal of entry for GBS into the bloodstream, subsequent crossing of the blood-brain barrier, and meningeal infection. Clinicians evaluating community-acquired meningitis in areas where tilapia is commonly handled should inquire about recent fish-related injuries and consider GBS in the differential diagnosis.
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