[Fulminant meningitis caused by Streptococcus pneumoniae. Report of three cases].
The prevalence of Streptococcus pneumoniae (S. pneumoniae) resistant to penicillin is an increasing problem with variable prevalence across the world. In Mexico, some reports inform prevalence as high as 50% of the isolations. S. penumoniae is a germ that produces a wide variety of diseases, although the most serious infections are in respiratory tract and meningitis. Most patients with the infection caused by this microorganism have a good response to the treatment. The cases with bad prognosis and those which are eventually lethal are related to host factors and microbiologic characteristics such as resistance to beta-lactam antibiotics. The aim of this paper is to inform on three cases of fulminant meningitis due to S. pneumoniae resistant to penicillin, which presented neurological focalization, acute loss of consciousness, coma, and death within the first week, in spite of treatment with cephalosporin of third and fourth generation. In all these cases, S. pneumoniae was isolated from cerebrospinal fluid. The presence of similar cases should alert the clinician to consider an early diagnosis of penicillin resistant meningitis in order to establish an appropriate antibiotic therapy, and consequently, modify the prognosis of the patients.
Departamento de Medicina Interna, Hospital de Especialidades, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social.
Luis Kenji
LK
Carmona-Furusho
C Raúl
CR
Ariza-Andraca
Felipe
F
Iniestra-Flores
Gabriel
G
Soto-Hernández
D000293:Adolescent; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008297:Male; D008586:Meningitis, Pneumococcal / Q000188:drug therapy*; D008875:Middle Aged; D010403:Penicillin Resistance