Extended-spectrum beta-lactamase (ESBL) producing organisms cause wide spectrum of diseases including urinary tract infection, cholangitis, intra-abdominal abscess or pneumonia but rarely meningitis. The present report a successful nonsurgical, medical treatment in a child with Escherichia coli ESBL meningitis with acute symptomatic communicating hydrocephalus and ventricular empyema. Incidence of infections from ESBL producing organisms are increasingly emerging and causing wide spectrum of illnesses which prompts for both aggressive medical and surgical intervention to prevent morbidity and mortality. Antimicrobial agents must be vigilantly utilized to prevent possible development of new highlyresistant organisms.

Keywords: Extended-spectrum beta-lactamase (ESBL), Escherichia coli, Meningitis