title: Purulent meningitis caused by Actinomyces successfully treated with rifampicin: a case report.
abstract: A 64-year-old woman presented with fever and headache. Lumbar puncture revealed cerebrospinal fluid (CSF) that contained 67,386 /mm(3) of WBC; CSF culture revealed Actinomyces species. She was diagnosed with purulent meningitis caused by actinomyces, and treated with intravenous ampicillin 12 g/day. The administration of ampicillin was effective, but not sufficient to control the inflammation in CSF. CSF inflammation persisted and a gradual increase in granulation tissue was found in the subdural space on lumbar MRI. After administration of rifampicin 450 mg/day, the CSF was normalized and the enhancement of granulation tissue decreased. The patient completely recovered 5 months after the therapy was initiated. We suggest that rifampicin may be an option for the treatment of meningitis caused by actinomyces.
authors.affiliation: Department of Neurology, Tottori Prefectural Central Hospital, Japan. imamurakeiko@nifty.com
authors.forename: Keiko
authors.initials: K
authors.lastname: Imamura
authors.forename: Hideki
authors.initials: H
authors.lastname: Kamitani
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nakayasu
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Asai
authors.forename: Kenji
authors.initials: K
authors.lastname: Nakashima
mesh_terms: D000190:Actinomyces / Q000302:isolation & purification / Q000472:pathogenicity; D000196:Actinomycosis / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D000667:Ampicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D016920:Meningitis, Bacterial / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D008875:Middle Aged; D012293:Rifampin / Q000627:therapeutic use*
chemical_list: D000900:Anti-Bacterial Agents; D000667:Ampicillin; D012293:Rifampin