[A case of recurrent bacterial meningitis by delayed cerebrospinal fluid (CSF) leakage due to a head trauma].
A 42-year-old man was admitted due to recurrent bacterial meningitis, as he had been treated here for bacterial meningitis three years prior to the current event. He had a remote history of head injury that he had almost forgotten, and his laboratory data showed no immunodeficiency state. 111In-DTPA cisternography showed an abnormal radioactive accumulation in the frontal lobe adjacent to the left frontal sinus at 23 hours after intrathecal injection, and MPR CT images revealed the left frontal sinus bone fracture. These findings indicated that he had a head injury by which a delayed CSF fistula has been formed. He was surgically treated for a CSF leakage. Although a combination therapy of ABPC and CTRX was efficacious for this patient, this regimen may not be ideal, as meningitis by PRSP has been increasing in incidence. Pneumococcal meningitis, once not a difficult infection to treat, could be a difficult one, as resistant strains to ABPC and CTRX have been more common.
Matsuda
Nozomu
N
Department of Neurology, Fukushima Medical University.
Matsuura
Yutaka
Y
Hoshi
Akihiko
A
Yamanoi
Takahiko
T
Endo
Kazuhiro
K
Honma
Mari
M
Yamamoto
Teiji
T
Sato
Sonomi
S
Kodama
Namio
N
D000328:Adult; D002558:Cerebrospinal Fluid Otorrhea / Q000209:etiology* / Q000601:surgery; D002559:Cerebrospinal Fluid Rhinorrhea / Q000209:etiology* / Q000601:surgery; D006259:Craniocerebral Trauma / Q000150:complications* / Q000601:surgery; D006801:Humans; D008297:Male; D008586:Meningitis, Pneumococcal / Q000188:drug therapy / Q000209:etiology*; D010403:Penicillin Resistance; D012008:Recurrence; D013296:Streptococcus pneumoniae / Q000187:drug effects