The European Journal of Case Reports in Internal Medicine is an official Journal of the European Federation of Internal Medicine (EFIM), representing 37 national societies from 35 European countries.
The Journal’s mission is to promote the best medical practice and innovation in the field of acute and general medicine. It also provides a forum for internal medicine doctors where they can share new approaches with the aim of improving diagnostic and clinical skills in this field. View full aims and scopes.
EJCRIM welcomes high-quality case reports describing unusual or complex cases that an internist may encounter in everyday practice. The cases should either demonstrate the appropriateness of a diagnostic/therapeutic approach, describe a new procedure or maneuver, or show unusual manifestations of a disease or unexpected reactions. The Journal only accepts and publishes those case reports whose learning points provide new insight and/or contribute to advancing medical knowledge both in terms of diagnostics and therapeutic approaches. Case reports of medical errors, therefore, are also welcome as long as they provide innovative measures on how to prevent them in the current practice (Instructive Errors).
The Journal may also consider brief and reasoned reports on issues relevant to the practice of Internal Medicine, as well as Abstracts submitted to the scientific meetings of acknowledged medical societies.

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João Cruz Cardoso, David Ferreira, Rui Assis, Joana Monteiro, Inês Coelho, André Real, Nuno Catorze

Streptococcus oralis is part of the normal flora of the oropharyngeal, nasal, gastrointestinal and genitourinary tracts. Classically, it shows low pathogenicity and virulence, but can very rarely cause meningitis in patients who have undergone dental procedures and have poor oral hygiene.
The purpose of this report is to highlight the importance of considering S. oralis as a cause of meningitis in patients with poor oral hygiene.
A 53-year-old man was admitted to the emergency department with high fever (39.4°C), headache and drowsiness. His mouth was unhygienic. He was diagnosed with meningitis and empiric antibiotics (ceftriaxone plus ampicillin) and dexamethasone were started. S. oralis was isolated from cerebrospinal fluid. Ampicillin and dexamethasone were stopped, while ceftriaxone was continued with full recovery of the patient.

Vol 8 No 4