Meningitis due to enterotoxigenic Bacteroides fragilis.
An enterotoxigenic strain of Bacteroides fragilis was the sole organism isolated from the cerebrospinal fluid of a two-and-a-half-month neonate who had a medullary-colonic fistula as part of a complex congenital malformation, but no brain abscess. A rapid latex particle agglutination test for detection of bacterial antigen was positive for Haemophilus influenzae type b, suggesting that Bacteroides fragilis and Haemophilus influenzae type b might share some capsular antigens. In order to determine the role of the enterotoxin with respect to virulence of the strain, antibodies to a 20 kDa protein were sought in the patient's serum, but Western blot of the culture supernatant revealed only antibodies to a 45 kDa bacterial protein. The patient was successfully treated with metronidazole and imipenem.
Aucher
P
P
Laboratoire de Microbiologie A, Centre Hospitalier Universitaire La Milètrie, Poitiers, France.
Saunier
J P
JP
Grollier
G
G
Sebald
M
M
Fauchère
J L
JL
D000907:Antibodies, Bacterial / Q000032:analysis; D000994:Antitrichomonal Agents / Q000627:therapeutic use; D001442:Bacteroides Infections / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000188:drug therapy; D001441:Bacteroides fragilis; D015153:Blotting, Western; D003937:Diagnosis, Differential; D004768:Enterotoxins / Q000032:analysis; D005189:False Positive Reactions; D006801:Humans; D015378:Imipenem / Q000627:therapeutic use; D007223:Infant; D007841:Latex Fixation Tests; D008297:Male; D016920:Meningitis, Bacterial / Q000175:diagnosis* / Q000188:drug therapy; D008583:Meningitis, Haemophilus / Q000175:diagnosis; D008795:Metronidazole / Q000627:therapeutic use; D013845:Thienamycins / Q000627:therapeutic use
D000907:Antibodies, Bacterial; D000994:Antitrichomonal Agents; D004768:Enterotoxins; D013845:Thienamycins; D008795:Metronidazole; D015378:Imipenem