Infection of central nervous system by motile Enterococcus: first case report.
A 66-year-old man with four indwelling ventriculoperitoneal shunts for multiloculated hydrocephalus from a complicated case of meningitis a year before developed shunt infection based on a syndrome of fever, drowsiness, and cerebrospinal fluid neutrophil pleocytosis in the background of repeated surgical manipulation to relieve successive shunt blockages. The cerebrospinal fluid culture, which yielded a motile Enterococcus species, was believed to originate from the gut. This isolate was lost in storage and could not be characterized further. The patient improved with vancomycin and high-dose ampicillin therapy. He relapsed a month later with Enterococcus gallinarum shunt infection, which responded to high-dose ampicillin and gentamicin therapy. This is probably the first case report of motile Enterococcus infection of the central nervous system.
Kurup
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Department of Internal Medicine, Singapore General Hospital, Singapore 169608. akurup99@yahoo.com
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D000368:Aged; D020806:Central Nervous System Bacterial Infections / Q000175:diagnosis* / Q000188:drug therapy; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D016983:Enterococcus / Q000145:classification / Q000302:isolation & purification / Q000502:physiology; D005334:Fever; D005839:Gentamicins / Q000627:therapeutic use*; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology / Q000601:surgery; D008297:Male; D008581:Meningitis / Q000150:complications; D008826:Microbial Sensitivity Tests; D012008:Recurrence; D014640:Vancomycin / Q000627:therapeutic use*; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects
D005839:Gentamicins; D014640:Vancomycin