Imipenem resistance in a case of AIDS with relapsing Pseudomonas meningitis.
We describe an AIDS patient who had a recurrence of Pseudomonas meningitis to illustrate three points. First, the use of sulfamethoxazole-trimethoprim in AIDS patients for prophylaxis of Pneumocystis carinii pneumonia may cause the various body sites to be colonized with resistant species such as P aeruginosa. Second, Pseudomonas meningitis can recur in a patient with AIDS after a month of appropriate therapy. Finally, imipenem is a poor choice for Pseudomonas meningitis, even when alternative therapies appear much less attractive. High doses of imipenem should not be used for fear of seizures, and lower doses only produce resistant organisms in the CSF.
Eng
R H
RH
Veterans Administration Medical Center, Orange, NJ 07019.
Lynch
A M
AM
Smith
S M
SM
Ambros
R A
RA
Fan-Havard
P
P
Mangia
A
A
Tecson-Tumang
F
F
Cherubin
C
C
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D004334:Drug Administration Schedule; D004341:Drug Evaluation; D004352:Drug Resistance, Microbial; D006801:Humans; D015378:Imipenem / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008581:Meningitis / Q000188:drug therapy* / Q000209:etiology; D011552:Pseudomonas Infections / Q000188:drug therapy*; D011550:Pseudomonas aeruginosa / Q000187:drug effects; D012008:Recurrence
D015378:Imipenem