title: [A case of recurrent bacterial meningitis by delayed cerebrospinal fluid (CSF) leakage due to a head trauma].
abstract: 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.
authors.affiliation: Department of Neurology, Fukushima Medical University.
authors.forename: Nozomu
authors.initials: N
authors.lastname: Matsuda
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Matsuura
authors.forename: Akihiko
authors.initials: A
authors.lastname: Hoshi
authors.forename: Takahiko
authors.initials: T
authors.lastname: Yamanoi
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Endo
authors.forename: Mari
authors.initials: M
authors.lastname: Honma
authors.forename: Teiji
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Sonomi
authors.initials: S
authors.lastname: Sato
authors.forename: Namio
authors.initials: N
authors.lastname: Kodama
mesh_terms: 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