title: [Klebsiella pneumoniae meningitis associated with liver abscess: a case report].
abstract: We report a rare case of Klebsiella pneumoniae meningitis associated with liver abscess, which was successfully treated with cefotaxime (CTX), one of the third-generation cephalosporins. A 53-year-old man was admitted to Keio University Hospital on June 13, 1988, because of a fever and a headache. On June 3, he suddenly started shivering and his temperature rose to 39 degrees C. He then began to complain of polydipsia, polyuria, and a weight loss of 4 kg a week. On June 11, he developed a severe headache. Four years prior to this incident, he had been diagnosed as having diabetes after a routine medical examination, but had neglected to undergo medical treatment. On admission, laboratory data showed leukocytosis, hyperglycemia (394 mg/dl) and ketonuria (4+). A lumbar puncture yielded cloudy cerebrospinal fluid (CSF) containing 500/3 cells/mm8, of which about 70% were neutrophils. A diagnosis of diabetic ketoacidosis and purulent meningitis was made. A treatment with ampicillin (ABPC) and CTX, (12 g/day, each) was begun. On the third day, cultures of a blood specimen and CSF yielded both K. pneumoniae. The MICs of CTX to K. pneumoniae isolated from blood and CSF were both 0.05 microgram/ml. ABPC was discontinued, gentamicin was administered for 2 days, CTX was continued at the same dosage level and an administration of prednisolone 40 mg daily was begun.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Internal Medicine, School of Medicine, Keio University.
authors.forename: T
authors.initials: T
authors.lastname: Yanagawa
authors.forename: H
authors.initials: H
authors.lastname: Nakamura
authors.forename: I
authors.initials: I
authors.lastname: Takei
authors.forename: H
authors.initials: H
authors.lastname: Maruyama
authors.forename: K
authors.initials: K
authors.lastname: Kataoka
authors.forename: T
authors.initials: T
authors.lastname: Saruta
authors.forename: Y
authors.initials: Y
authors.lastname: Kobayashi
mesh_terms: D002439:Cefotaxime / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007710:Klebsiella Infections; D007711:Klebsiella pneumoniae; D008100:Liver Abscess / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008581:Meningitis / Q000188:drug therapy / Q000209:etiology*; D008875:Middle Aged; D018805:Sepsis / Q000150:complications / Q000188:drug therapy
chemical_list: D002439:Cefotaxime