72-year-old Vietnamese man with E. coli meningitis and tapeworm infection

A 72‑year‑old man from Ninh Bình, Vietnam, was admitted with severe headache and slowed consciousness. Cerebrospinal fluid analysis showed increased cells and protein, leading to a diagnosis of bacterial meningitis. Laboratory testing identified Escherichia coli in the CSF, an unusual finding because the bacterium normally resides in the intestinal tract. Further tests revealed the patient was also infected with a tapeworm (giun lươn), which doctors believe may have facilitated the translocation of gut bacteria into the bloodstream.

The patient’s condition deteriorated rapidly, developing septic shock, hypotension, and requiring intubation, mechanical ventilation, and high‑dose vasopressors. He was transferred to the Central Tropical Disease Hospital’s Intensive Care Unit, where he received targeted antibiotic therapy based on susceptibility testing. Dr. Nguyen Duc Hieu noted, “E. coli is normally a gut resident but its presence in CSF is a special warning sign, especially in an elderly patient with liver fibrosis.” The case highlights the potential role of parasitic infections in enabling severe bacterial invasions in vulnerable patients.