Successful meropenem therapy of a brain abscess and meningitis arising from acute purulent otomastoiditis: case report.
We describe a case of a 25-year-old female with an acute left otomastoiditis, accompanied by a left temporal extradural abscess with moderate perifocal edema and meningitis. Intravenous meropenem (2 g 8-hourly) and intravenous methylprednisolone (40 mg once daily) were commenced empirically. Teicoplanin (400 mg once daily intravenously) was added after 5 days when culture results were available. Teicoplanin was discontinued on day 25 but meropenem and methylprednisolone were continued for a further 15 days, after which the abscess completely resolved without sequelae. No treatment-induced adverse effects or seizures were observed. Thus, in selected patients, antibacterials (in conjunction with a corticosteroid) may be successfully used without surgery to treat brain abscesses and in such circumstances meropenem is a useful option for empiric therapy.
Paffetti
A
A
Department of Tropical and Infectious Diseases, Policlinico Umberto 1, University La Sapienza of Rome, Italy.
D'Aviera
L
L
Le Foche
F
F
Mannozzi
P
P
Mastropietro
C
C
Croce
G F
GF
Ferretti
G
G
Rossi
F
F
D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001922:Brain Abscess / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D001929:Brain Edema / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology; D004359:Drug Therapy, Combination / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008417:Mastoiditis / Q000150:complications*; D008581:Meningitis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D000077731:Meropenem; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use; D017334:Teicoplanin / Q000008:administration & dosage / Q000627:therapeutic use; D013845:Thienamycins / Q000008:administration & dosage / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed
D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D013845:Thienamycins; D017334:Teicoplanin; D000077731:Meropenem; D008775:Methylprednisolone