title: Intravenous metronidazole therapy for Bacteroides fragilis meningitis.
abstract: A 69-year-old man developed meningitis due to Bacteroides fragilis and Streptococcus MG-intermedius, which progressed during chloramphenicol and nafcillin therapy to the extent that he seemed near death, with frank pus covering the spinal cord at surgery. Treatment with intravenous metronidazole and penicillin G was curative. After multiple trauma, a 20-year-old man developed meningitis due to Escherichia coli and B fragilis. He failed to respond to chloramphenicol alone, but responded to combined treatment with chloramphenicol and metronidazole. The right frontal sinus and epidural space abscesses were drained and a right frontal lobe abscess was excised. Metronidazole may be a uniquely effective agent for treatment of meningitis due to susceptible strains of Bacteroides fragilis.
mesh_terms: D000328:Adult; D000368:Aged; D001442:Bacteroides Infections / Q000188:drug therapy*; D001441:Bacteroides fragilis; D002701:Chloramphenicol / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004927:Escherichia coli Infections / Q000188:drug therapy; D006801:Humans; D007263:Infusions, Parenteral; D008297:Male; D008581:Meningitis / Q000188:drug therapy*; D008795:Metronidazole / Q000008:administration & dosage* / Q000627:therapeutic use; D009254:Nafcillin / Q000627:therapeutic use; D010400:Penicillin G / Q000627:therapeutic use; D013290:Streptococcal Infections / Q000188:drug therapy
chemical_list: D008795:Metronidazole; D009254:Nafcillin; D002701:Chloramphenicol; D010400:Penicillin G