Community-acquired Escherichia coli meningitis in adult.

We report a case of E. coli meningitis presented initially without nuchal rigidity. Despite intensive care treatment, CSF was not sterilized and the patient died at 17 days after his admission. Patients with an unexplained altered sensorium with fever should undergo LP to evaluate for this rare entity and to direct early antimicrobial treatment which possesses efficacy for meningeal infection.