Crossing boundaries: E. coli meningitis as an uncommon complication of hemorrhoidectomy

<i>Escherichia coli</i> meningitis is a rare cause of meningitis in adults. Overall, mortality due to meningitis is improving, but remains high for gram negative bacteria. It often progresses rapidly, and even if treated appropriately, can lead to long-term complications. An emerging concern is bacterial resistance to the empiric antibiotic regimen used in meningitis. The effect of adjunct dexamethasone on reducing mortality or preventing complications remains inconclusive. Here, we discuss a case of severe <i>E. coli</i> meningitis in a 56-year-old woman after a hemorrhoidectomy, leading to brain herniation and cardiac arrest.