Danger of corticosteroid administration in meningitis due to misdiagnosed agent.
A 3 1/2-year-old child with acute tuberculous meningitis was misdiagnosed as having "partially treated" meningitis and was treated with ampicillin, chloramphenicol, and dexamethasone. She developed obstructive hydrocephalus and miliary spread of tuberculosis which led to death. It is likely that failure to consider alternative diagnoses promptly and the use of corticosteroids along with ineffective antibiotics contributed to the outcome. Although they may lessen some complications of bacterial meningitis, the indiscriminate use of corticosteroids in misdiagnosed bacterial meningitis may be detrimental.
Davis
L E
LE
Neurology Service, Veterans Administration Hospital, Albuquerque, New Mexico 87108.
D000667:Ampicillin / Q000627:therapeutic use; D002675:Child, Preschool; D002701:Chloramphenicol / Q000627:therapeutic use; D000075202:Contraindications; D003907:Dexamethasone / Q000009:adverse effects* / Q000627:therapeutic use; D003951:Diagnostic Errors; D004352:Drug Resistance, Microbial; D005260:Female; D006801:Humans; D016920:Meningitis, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D009169:Mycobacterium tuberculosis / Q000187:drug effects; D016896:Treatment Outcome; D014390:Tuberculosis, Meningeal / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology
D002701:Chloramphenicol; D000667:Ampicillin; D003907:Dexamethasone