13 May 2026
: Case report 
Meningoencephalitis Caused by Escherichia coli in an Adult With No Known Immunocompromising Conditions: A Case Report
Challenging differential diagnosis, Rare disease
Silviya Stoyanova
ABCDEF 1, Emilia Naseva BCDEF 2*, Tsvetelina Velikova CDEF 3, Zorka Ramsheva BCDEF 4, Konstantin Ramshev ABCDEF 1
DOI: 10.12659/AJCR.953021
Am J Case Rep 2026; 27:e953021
Table 2 RT-PCR of CSF for the 14 most common causative agents of meningitis and encephalitis and microbiological examination with antibiogram of CSF and urine.
| PCR CSF | Microbiology CSF | Initial urine microbiology | Follow-up urine microbiology | ||||
|---|---|---|---|---|---|---|---|
| Escherichia coli | Escherichia coli >105 | Escherichia coli >105 | |||||
| Positive | Amikacin | S | Amikacin | S | Amikacin | R | |
| Negative | Amoxicillin | R | Amoxicillin | R | Amoxicillin | R | |
| Negative | Ampicillin | S | Ampicillin | S | Ampicillin | R | |
| Negative | Ampicillin/sulbactam | S | Ampicillin/sulbactam | S | Ampicillin/sulbactam | R | |
| Negative | Cefepime | S | Cefepime | S | Cefepime | R | |
| Negative | Cefixime | S | Cefixime | S | Cefixime | R | |
| Negative | Ceftazidime | S | Ceftazidime | S | Ceftazidime | R | |
| Enterovirus | Negative | Ceftriaxone | S | Ceftriaxone | S | Ceftriaxone | R |
| Herpes simplex 1/2 | Negative | Cefuroxime | I | Cefuroxime | I | Cefuroxime | R |
| Human herpes virus 6 | Negative | Ciprofloxacin | R | Ciprofloxacin | R | Ciprofloxacin | R |
| Negative | Colistin | S | Colistin | S | Colistin | R | |
| Varicella zoster virus | Negative | Gentamicin | S | Gentamicin | S | Gentamicin | R |
| Negative | Imipenem | S | Imipenem | S | Imipenem | R | |
| Negative | Levofloxacin | R | Levofloxacin | R | Levofloxacin | R | |
| Meropenem | S | Meropenem | S | Meropenem | R | ||
| Norfloxacin | R | Norfloxacin | R | Norfloxacin | R | ||
| Piperacillin/tazobactam | S | Piperacillin/tazobactam | S | Piperacillin/tazobactam | R | ||
| Tetracycline | R | Tetracycline | R | Tetracycline | R | ||
| Trimethoprim/sulfamethoxazole | R | Trimethoprim/sulfamethoxazole | R | Trimethoprim/sulfamethoxazole | R | ||
| Cefoperazon/sulbactam | S | Cefoperazon/sulbactam | S | Cefoperazon/sulbactam | R | ||
| Doxycycline | R | Doxycycline | R | Doxycycline | R | ||
| Cefpodoxime | S | Cefpodoxime | S | Cefpodoxime | R | ||
| Cefazolin | R | Cefazolin | R | Cefazolin | R | ||
| Ertapenem | S | Ertapenem | S | Ertapenem | R | ||
| Nalidix acid | R | Nalidix acid | R | Nalidix acid | R | ||
| Nitrofurantoin | S | Nitrofurantoin | S | Nitrofurantoin | S | ||
| Amoxicillin/clavulanic acid | S | Amoxicillin/clavulanic acid | S | Amoxicillin/clavulanic acid | R | ||
| S – susceptible; I – intermediary; R – resistance. | |||||||