Meningitis caused by Mycobacterium fortuitum.
A previously healthy 16-yr-old Caucasian male developed a relapsing purulent meningitis shortly after a motor accident in Venezuela, in which he received a small wound with a retained foreign body in the sacral region. Repeated initial physical examinations, radiographs of lumbar and sacral regions, and contrast myelography failed to demonstrate a cerebrospinal fluid leak or bone involvement, and Mycobacterium fortuitum was repeatedly isolated from the cerebrospinal fluid. Finally, from the originally "cured" lumbar wound a purulent material was obtained from which M. fortuitum was also isolated. A retained foreign body was removed, and an abscess and fistulous tract were incised and drained. The patient responded dramatically to the combination of isoniazid plus co-trimoxazole and surgery.
D000293:Adolescent; D019567:Back Injuries; D005549:Foreign-Body Reaction / Q000150:complications; D006801:Humans; D008297:Male; D008581:Meningitis / Q000209:etiology*; D009164:Mycobacterium Infections; D012445:Sacrococcygeal Region; D014950:Wounds, Penetrating