猪链球菌脑膜炎患者可并发视力和听力障碍，严重影响患者恢复后的生活质量。本科室收治1例59岁男性患者，以头痛伴发热起病，随后出现双眼视力下降、右耳听力减退。神清语明，双眼视力下降，仅有光感，双耳听力下降（以右侧为著），颈强3横指，Kernig征阳性。磁共振成像（MRI）头部平扫示右侧额叶白质区片状异常信号，进一步完善MRI头部增强扫描，未见异常信号；脑脊液外观呈头滴带血后微黄浑浊，白细胞总数明显升高、蛋白水平升高；葡萄糖和氯水平降低，多核细胞百分率79%，脑脊液中免疫球蛋白（IgG）82.25 mg·L^-1；血培养提示猪链球菌；脑脊液病原微生物宏基因组测序（mNGS）提示革兰阳性菌，猪链球菌序列数为7 001条。诊断为猪链球菌脑膜炎，给予抗感染、激素及对症治疗。分别于出院后6和18个月随访，视力恢复尚可，听力较出院时无明显好转。对于有过病（死）猪接触史的患者，如出现脑膜炎，并有眼和耳等其他脏器同时受累表现时，应考虑猪链球菌脑膜炎，应及早给与经验性抗感染治疗，并行血培养及mNGS明确诊断。联合应用猪链球菌敏感抗生素和地塞米松有助于改善患者听力障碍。

The Streptococcus suis meningitis patients often accompany with visual and hearing impairment， and their life quality is affected seriously after recovery. Our department admitted a 59-year-old male patient. The patient presented headache accompanied by fever， followed by decreased vision acuity in both eyes and reduced hearing in the right ear. The patient was alerted and oriented， with only light sensation in both eyes and reduced hearing in both ears （more pronounced on the right side）. The neck strength was 3 horizontal fingers， and Kernig sign was positive. Magnetic resonance imaging （MRI） head scan showed patchy abnormal signals in the white matter of the right frontal lobe， while further enhanced MRI scan did not reveal any abnormal signals. The cerebrospinal fluid appeared slightly yellow and turbid color with blood droplets at the initial drip， and the total number of leukocytes and protein level were significantly increased.The glucose and chloride levels were decreased with the multinucleated cells accounting for 79% of the cellular components. The cerebrospinal fluid IgG level was 82.25 mg·L^-1. Blood culture yielded Streptococcus suis as the causative pathogen. Metagenomic next generation sequencing （mNGS） in cerebrospinal fluid indicated Gram-positive bacteria， with 7 001 Streptococcus suis sequences detected. The patient was diagnosed with Streptococcus suis meningitis and treated with anti-infective therapy complemented by hormone and symptomatic treatment. Follow-up interviews at 6 and 18 months post-discharge revealed a satisfactory recovery of visual acuity， while the hearing did not improve significantly compared to at the time of discharge. In the patients with a history of exposure with sick or dead pigs who develop signs of meningitis accompanied by simultaneous involvement of other organs such as eyes and ears， Streptococcus suis meningitis should be considered and empirical anti-infective treatment should be provided as soon as possible. Blood culture and mNGS for definitive diagnosis should be conducted promptly. Combined application of Streptococcus suis-sensitive antibiotics and dexamethasone may help improve hearing impairments in these patients.