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Case Report Open Access

Bacterial meningoencephalitis following allogeneic hematopoietic stem cell transplantation: A case report and literature review

  • Authors:
    • Yajun Shi
    • Ying Han
    • Jinjin Chen
    • Heng Liu
    • Xiaofei Zhang
    • Rui Song
    • Xuejie Ma
    • Qiangsheng Feng
    • Tao Wu
  • View Affiliations / Copyright

    Affiliations: Department of Hematology, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou, Gansu 730050, P.R. China, Clinical Laboratory, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou, Gansu 730050, P.R. China
    Copyright: © Shi et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 174
    |
    Published online on: April 24, 2026
       https://doi.org/10.3892/etm.2026.13169
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Abstract

Bacterial meningoencephalitis (BME) following allogeneic hematopoietic stem cell transplantation (allo‑HSCT) seriously affects the survival of recipients, though it is rarely reported. The present study reported on a 21‑year‑old man with Ph+ acute B‑lymphocytic leukemia who suddenly had a severe headache, fever and neuropsychiatric disturbances, and quickly became barely conscious at 483 days post‑allo‑HSCT. Streptococcus pneumoniae (S. pneumoniae) was found in cerebrospinal fluid (CSF) and blood, and the patient was eventually diagnosed with BME. The patient had received empirical antibacterial treatment with meropenem and vancomycin, as well as anti‑inflammatory treatment with dexamethasone, before S. pneumoniae was detected in CSF. Headache and fever were quickly relieved. However, due to the delay of antibacterial treatment outside the hospital, the patient presented with severe neurological sequelae in an unconscious state. In conclusion, impaired immune reconstitution post‑transplantation increases the risk of BME, a rapidly progressive disease with high disability and mortality rates. This case highlights that recipients presenting with central nervous system symptoms, early identification and diagnosis of BME, as well as empirical antibacterial treatment within 6 h before lumbar puncture, significantly improve the survival of patients.
View Figures

Figure 1

Immunosuppressive and antimicrobial
therapy timelines in the patient with BME following allo-HSCT. (A)
Immunosuppressive therapy in a patient after allo-HSCT. (B)
Antimicrobial therapy in a patient with BME. BME, bacterial
meningoencephalitis; allo-HSCT, allogeneic hematopoietic stem cell
transplantation; d, days.

Figure 2

Cranial MRI findings in a patient
with bacterial meningoencephalitis pre- and post-treatment
following allogeneic hematopoietic stem cell transplantation. (A)
Contrast-enhanced cranial MRI at onset revealed abnormal
enhancement of the leptomeninges of the bilateral cerebral and
cerebellar hemispheres, the tentorium cerebelli and the ependyma.
(B) Cranial MRI FLAIR at onset showed a small amount of empyema in
the posterior horns of the lateral ventricles and (C) dilation of
the supratentorial third ventricle and bilateral lateral
ventricles, indicating hydrocephalus. (D) Cranial MRI FLAIR at
onset showed periventricular interstitial edema. (E) Cranial MRI
T2WI, (F) FLAIR and (G) DWI at the time of clinical deterioration
all demonstrated meningoencephalitis involving the bilateral
cerebral hemispheres, predominantly in the right temporoparietal
region. (H) Cranial MRI DWI at deterioration revealed a small
amount of empyema in the posterior horns of the lateral ventricles.
(I) Cranial MRI T1WI at two years showed laminar necrosis in parts
of the bilateral cerebral cortices. (J) Cranial MRI T2WI at two
years demonstrated localized atrophy, encephalomalacia, and gliosis
in the bilateral frontal, temporal, parietal, occipital lobes, and
(K) laminar necrosis in parts of the bilateral cerebral cortices.
(L) Cranial MRI FLAIR at two years showed brain atrophy. MRI,
magnetic resonance imaging; FLAIR, fluid-attenuated inversion
recovery; T2WI, T2-weighted imaging; DWI, diffusion-weighted
imaging.
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Shi Y, Han Y, Chen J, Liu H, Zhang X, Song R, Ma X, Feng Q and Wu T: Bacterial meningoencephalitis following allogeneic hematopoietic stem cell transplantation: A case report and literature review. Exp Ther Med 31: 174, 2026.
APA
Shi, Y., Han, Y., Chen, J., Liu, H., Zhang, X., Song, R. ... Wu, T. (2026). Bacterial meningoencephalitis following allogeneic hematopoietic stem cell transplantation: A case report and literature review. Experimental and Therapeutic Medicine, 31, 174. https://doi.org/10.3892/etm.2026.13169
MLA
Shi, Y., Han, Y., Chen, J., Liu, H., Zhang, X., Song, R., Ma, X., Feng, Q., Wu, T."Bacterial meningoencephalitis following allogeneic hematopoietic stem cell transplantation: A case report and literature review". Experimental and Therapeutic Medicine 31.6 (2026): 174.
Chicago
Shi, Y., Han, Y., Chen, J., Liu, H., Zhang, X., Song, R., Ma, X., Feng, Q., Wu, T."Bacterial meningoencephalitis following allogeneic hematopoietic stem cell transplantation: A case report and literature review". Experimental and Therapeutic Medicine 31, no. 6 (2026): 174. https://doi.org/10.3892/etm.2026.13169
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Spandidos Publications style
Shi Y, Han Y, Chen J, Liu H, Zhang X, Song R, Ma X, Feng Q and Wu T: Bacterial meningoencephalitis following allogeneic hematopoietic stem cell transplantation: A case report and literature review. Exp Ther Med 31: 174, 2026.
APA
Shi, Y., Han, Y., Chen, J., Liu, H., Zhang, X., Song, R. ... Wu, T. (2026). Bacterial meningoencephalitis following allogeneic hematopoietic stem cell transplantation: A case report and literature review. Experimental and Therapeutic Medicine, 31, 174. https://doi.org/10.3892/etm.2026.13169
MLA
Shi, Y., Han, Y., Chen, J., Liu, H., Zhang, X., Song, R., Ma, X., Feng, Q., Wu, T."Bacterial meningoencephalitis following allogeneic hematopoietic stem cell transplantation: A case report and literature review". Experimental and Therapeutic Medicine 31.6 (2026): 174.
Chicago
Shi, Y., Han, Y., Chen, J., Liu, H., Zhang, X., Song, R., Ma, X., Feng, Q., Wu, T."Bacterial meningoencephalitis following allogeneic hematopoietic stem cell transplantation: A case report and literature review". Experimental and Therapeutic Medicine 31, no. 6 (2026): 174. https://doi.org/10.3892/etm.2026.13169
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