[Enterococcal meningitis in adults].
BACKGROUND
In recent years, Enterococcus species have emerged as significant human pathogens capable of causing a variety of nosocomial and community-acquired infections. However, enterococcal meningitis (EM) is an uncommon disease. This study describes the clinical features and outcome of EM in adults seen at a tertiary hospital during 25 years.


METHODS
We reviewed the charts of all patients (aged > or = 14 years) evaluated between 1982 and 2006 with EM.


RESULTS
Six cases of EM were diagnosed (4,2% of culturepositive bacterial meningitis), with a mean age of 67 years (range, 47-83). All cases had postoperative meningitis, and the most common predisposing condition was the presence of CSF devices (5 cases). The clinical course was acute (duration of symptoms of one day in 5 cases). Most patients presented with fever and headache (5 cases), and changes in mental status (4 cases). The most common CSF abnormalities were pleocytosis (6 cases), elevated protein level (6 cases), and hypoglycorrhachia (3 cases). Gram CSF stain was positive in one case, and culture in all cases (4 were E. faecalis and 2 were E. faecium). Treatment included vancomycin (5 cases) or ampicillin plus gentamicin (one case), CSF devices were removed in all patients, and there were no deaths or sequelae.


CONCLUSIONS
EM is an uncommon disease, most of cases had a postoperative origin, and CSF devices are the most common predisposing condition. A favourable outcome was observed in the cases reported.
Laguna Del Estal
P
P
Servicio de Medicina Interna, Hospital Universitario Puerta de Hierro, Madrid. pdl02m@saludalia.com
García Zubiri
C
C
García Madero
R
R
Gil Navarro
M
M
D000368:Aged; D000369:Aged, 80 and over; D000667:Ampicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects; D016983:Enterococcus; D013293:Enterococcus faecalis; D016984:Enterococcus faecium; D005260:Female; D005839:Gentamicins / Q000627:therapeutic use; D016908:Gram-Positive Bacterial Infections / Q000134:cerebrospinal fluid / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D008297:Male; D016920:Meningitis, Bacterial / Q000134:cerebrospinal fluid / Q000188:drug therapy / Q000382:microbiology*; D008875:Middle Aged; D016896:Treatment Outcome; D014640:Vancomycin / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D005839:Gentamicins; D014640:Vancomycin; D000667:Ampicillin