title: A case of meningococcal meningitis that was difficult to treat owing to concurrent ventriculitis.
abstract: A 64-year-old male came to our hospital emergency department with fever and consciousness disturbance. Culture tests of blood and spinal fluid samples revealed meningococci (Neisseria meningitidis), and we made a diagnosis of meningococcal meningitis. Brain magnetic resonance imaging (MRI) findings revealed ventriculitis. Ceftriaxone was administered for 17 days, however, relapse was noted after that was discontinued, with neutropenia and renal impairment thought to be adverse reactions to the beta-lactam antibiotic. Hence, treatment was switched to oral administration of moxifloxacin for a total of 12 weeks, including in an outpatient setting. After moxifloxacin was discontinued, no side effects or relapse were seen, and treatment was ended. Although antibacterial agents generally show favorable effects for meningococcal meningitis, we consider that sufficient antimicrobial therapy is difficult in cases complicated with ventriculitis.
authors.affiliation: Department of Neurology, Showa General Hospital.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nakahara
authors.forename: Toshimi
authors.initials: T
authors.lastname: Oda
authors.forename: Eri
authors.initials: E
authors.lastname: Fukao
authors.forename: Izumi
authors.initials: I
authors.lastname: Horiuchi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Honma
authors.forename: Masanobu
authors.initials: M
authors.lastname: Uchigata
mesh_terms: D060433:Administration, Ophthalmic; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects; D002443:Ceftriaxone / Q000008:administration & dosage / Q000009:adverse effects; D058565:Cerebral Ventriculitis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology*; D057915:Drug Substitution; D024841:Fluoroquinolones / Q000008:administration & dosage; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008585:Meningitis, Meningococcal / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D008875:Middle Aged; D000077266:Moxifloxacin; D012008:Recurrence; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D002443:Ceftriaxone; D000077266:Moxifloxacin