We report a case of S. bovis meningitis in a previously healthy man who was subsequently found to have a villous adenoma of the colon. A 41-year-old man with no significant medical history was admitted to the hospital for evaluation of acute changes in mental status. The patient was confused and disoriented on presentation. Cultures of specimens of the CSF yielded S. bovis . The patient was treated with a 14-day course of iv penicillin G (24 million units per day) as well as a 3-day course of iv dexamethasone (12 mg very 12 hours). The patient responded well to therapy. Colonoscopy was performed and revealed a 3-mm adenomatous polyp in the lower portion of the ascending colon; a polypectomy was then performed.