title: Acute bacterial meningitis with coincident methamphetamine use: a case report and review of the literature.
abstract: Methamphetamine is a synthetic stimulant that can adversely affect the central nervous system and the immune system. Through various mechanisms, methamphetamine is toxic to neurons, endothelial cells, lymphocytes, granulocytes, and macrophages resulting in systemic damage. Reported is the sudden demise of an otherwise healthy 31-year-old woman with a history of stimulant abuse. At autopsy, acute bacterial meningitis was identified. Microbiology cultures grew a single isolate of Streptococcus pneumoniae. Toxicology was positive for amphetamine (0.13 mg/L) and methamphetamine (0.8 mg/L). The cause of death was classified as acute bacterial meningitis with methamphetamine use. Either the acute bacterial meningitis or the methamphetamine toxicity would have been sufficient to result in death; however, the concurrent pathophysiology of the two entities must be understood. A review of the current literature assesses the mechanisms of injury attributed to acute and chronic methamphetamine use, bacterial meningitis, and the synergy between the two.
authors.affiliation: Fulton County Medical Examiner's Office, 430 Pryor Street SW, Atlanta, GA 30312, USA. michael.heninger@fultoncountyga.gov
authors.forename: Michael
authors.initials: M
authors.lastname: Heninger
authors.forename: Kim A
authors.initials: KA
authors.lastname: Collins
mesh_terms: D000208:Acute Disease; D000328:Adult; D019969:Amphetamine-Related Disorders / Q000150:complications*; D000697:Central Nervous System Stimulants / Q000009:adverse effects / Q000097:blood / Q000652:urine; D005260:Female; D049429:Forensic Pathology; D006801:Humans; D008578:Meninges / Q000473:pathology; D016920:Meningitis, Bacterial / Q000175:diagnosis* / Q000382:microbiology; D008694:Methamphetamine / Q000009:adverse effects / Q000097:blood / Q000652:urine; D011008:Pneumococcal Infections / Q000175:diagnosis*; D013296:Streptococcus pneumoniae / Q000302:isolation & purification
chemical_list: D000697:Central Nervous System Stimulants; D008694:Methamphetamine
keywords: amphetamine; autopsy; bacterial meningitis; blood-brain barrier; death investigation; forensic pathology; forensic sciences; forensic toxicology; methamphetamine; pneumococcal