An Unusual Presentation of Multiple Myeloma with High Grade Fever and Loss of Consciousness

Patients with multiple myeloma (MM) are susceptible to bacterial infections, particularly those caused by encapsulated pyogenic bacteria such as Streptococcus pneumoniae. Significant morbidity and mortality attributable to these infections has been reported in patients with MM. Insufficient synthesis of polyclonal immunoglobulins reflected in marked hypogammaglobulinemia is an important underlying mechanism responsible for the compromised immune system in patients with MM. Despite the fact that patients with MM are prone to develop sepsis caused by encapsulated bacteria, an acute bacterial infection is rarely reported as the first manifestation of underlying MM. Here, we report a rare presentation of MM with hyperacute bacterial meningitis.