Introduction: The Pseudomonas genus comprises of several species with the majority of reported infections caused by Pseudomonas aeruginosa. Pseudomonas stutzeri is a member of this genus and is widely distributed in the environment. It is a ubiquitous Gram-negative bacterium responsible for infections particularly in immunocompromised patients but was rarely been reported as a cause of meningitis.

Case Description: Case of 65 years old woman was admitted for investigation of right nipple retractions and recurrent headaches. She was found to have Pseudomonas stutzeri in CSF culture that was treated with ceftazidime. In addition, meningeal metastasis from primary breast cancer was discovered. PET scan confirmed the primary cancerous mass in the right breast which was started on chemotherapy.

Discussion: The case presented shows a rare combination of community acquired meningitis caused by Pseudomonas stutzeri with leptomeningeal metastasis originating from breast cancer. The patient had no prior neurosurgical procedure that predisposes to Pseudomonas strains invading the meninges. It was supposed that the leptomeningeal metastasis was behind this breach.

Conclusion: It should always be remembered to suspect atypical germs in atypical presentations and to search for a possible explanation when a germ similar to Pseudomonas stutzeri cause invasive infection.

Keywords: Pseudomonas stutzeri; Breast mass; Meningeal metastases