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Table 1 Case-patient timeline

From: Human meningitis due to Streptococcus suis in Lomé, Togo: a case report

  Presenting concerns Physical examination Evaluations Diagnosis Interventions-Treatments
Day of admission 32-year-old man, carpenter in Lomé No particular medical history
3-day history of headaches, agitation, vomiting, fever
Body temperature: 36.4 °C Neurological examination: normal Clinical examination: normal Cranial computed tomography: not performed Acute meningeal hemorrhage Symptomatic treatment
Day 2 Persisting symptoms Fever Neck stiffness Kernig and Brudzinski signs positive Lumbar puncture: turbid CSFa
CSF analysis: -WBCa: 2,800/mm3 (65 % lymphocytes,35 % neutrophils)
- Protein: 1.8 g/L - Glucose: 0.47 g/L (plasma 1.41 g/L; ratio = 0.33) - Gram stain: negative
Bacterial meningitis Wide-spectrum antibiotic therapy: ceftriaxone, ofloxacin, metronidazole
Day 3 Vertigo
Tinnitus
  CSF culture positive: catalase negative, gram-positive cocci in chains   Adapted antibiotic therapy: ampicillin, gentamicin Corticoid therapy
Day 4 Patient reported working as a pork butcher every weekend   Bacterial identification: Streptococcus suis Audiogram: severe hearing loss in left and right ears (80 dB) Bacterial meningitis due to S. suis with neurological complications  
Month 9 Tinnitus   Audiogram: severe hearing loss in left and right ears (80 dB) Neurological sequelae of the meningitis  
  1. aCSF cerebrospinal fluid, WBC white blood cells