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CASE REPORT
Year : 2022  |  Volume : 49  |  Issue : 2  |  Page : 207-209

Bacterial meningitis as the first presentation of multiple myeloma


1 Department of Critical Care, Datta Meghe Institute of Medical Sciences (Deemed to be University), Jawaharlal Nehru Medical College, Wardha, Maharashtra, India
2 Department of Pathology, Datta Meghe Institute of Medical Sciences (Deemed to be University), Jawaharlal Nehru Medical College, Wardha, Maharashtra, India
3 Department of Medicine, Datta Meghe Institute of Medical Sciences (Deemed to be University), Jawaharlal Nehru Medical College, Wardha, Maharashtra, India
4 Department of Nephrology, Datta Meghe Institute of Medical Sciences (Deemed to be University), Jawaharlal Nehru Medical College, Wardha, Maharashtra, India

Correspondence Address:
Samarth Shukla
Department of Pathology, Datta Meghe Institute of Medical Sciences (Deemed to be University), Jawaharlal Nehru Medical College, Sawangi, Meghe, Wardha - 442 004, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jss.jss_34_22

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Multiple myeloma (MM) is a monoclonal gammopathy. Patients with MM are vulnerable to infections, especially by encapsulated bacteria. These infections have been associated with severe morbidity and mortality in MM. A key underlying cause of the immune system's decline in MM is insufficient production of polyclonal immunoglobulin, which manifests as severe hypogammaglobulinemia. An acute bacterial infection is rarely the first sign of the disease. We present a case of a 65-year-old male who presented to us with fever and disorientation. Clinical examination revealed signs of meningeal irritation. Cerebrospinal fluid study confirmed bacterial meningitis. Associated features such as renal failure, high erythrocyte sedimentation rate, hyperglobulinemia, and anemia lead to suspicion of MM which was later confirmed by serum electrophoresis.


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