[Streptococcus pneumoniae meningitis treated successfully with polymyxin B-immobilized fiber therapy: a case report].
A-61-year old man was admitted to our hospital with fever and severe disturbance of consciousness. He was diagnosed with Streptococcus pneumoniae meningitis on the basis of cerebrospinal fluid (CSF) analysis and urinary antigen detection by immunochromatography. Although he was treated with dexamethasone and antibiotics, his general status worsened as systemic inflammatory response syndrome (SIRS), disseminated intravascular coagulation (DIC), and status epileptics developed. Following treatment with polymyxin B-immobilized fiber therapy (PMX), which can also absorb bacteria-derived toxic substances, he recovered from DIC and SIRS, and disturbance of consciousness improved immediately. In addition, the concentration of several CSF cytokines--IL-1, IL-2, and TNF-α--was decreased. The present case suggests that PMX is a good option for severe bacterial meningitis.
Department of Neurology, Omori Red Cross Hospital.
Yoko
Y
Suzuki
Shingo
S
Kawakami
Minako
M
Yamada
Hirofumi
H
Nakase
D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008586:Meningitis, Pneumococcal / Q000188:drug therapy*; D008875:Middle Aged; D011112:Polymyxin B / Q000008:administration & dosage*
D000900:Anti-Bacterial Agents; D011112:Polymyxin B