ABSTRACT
We reported 51 year old man from Kanchanaburi Province presented with acute bacterial meningitis. The pathogenic bacteria was identified as g-haemolytic streptococci ( non gr D ). The cerebrospinal fluid (CSF) showed lymphocytic pleocytosis which were indistinguishable to tuberculous or fungal infections. After treatment with penicillin and third generation cephalosporin for 2 weeks, CSF culture for bacteria was negative, but the symptoms were still persisting and later on developed sensorineural hearing loss. Antibiotics were continued for another 6 weeks. Patient responsed to medication well but complicated with hydrocephalus and sensorineural hearing loss that both were treated promptly. The most likely pathogenic organism in this patient is Streptococcus suis.