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[A case of acute pneumococcal meningitis treated with spinal drainage and vancomycin administration]

Akiko Fujita1, Atsuko Kobayashi, Muneyoshi Tagami

  • 1Division of Anesthesiology, Saiseikai Suita Hospital, Osaka 564-0025.

Masui. the Japanese Journal of Anesthesiology
|November 6, 2003
PubMed

Insights

This case study highlights a severe pneumococcal meningoencephalitis case. Intrathecal vancomycin and lumbar drainage improved outcomes when conventional therapy failed.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Pharmacology

Background:

  • Pneumococcal meningoencephalitis is a severe infection affecting the brain and meninges.
  • Standard treatment involves antibiotics, but resistance or complications can occur.

Observation:

  • A 25-year-old female presented with severe symptoms including fever, headache, and nuchal rigidity, diagnosed via cerebrospinal fluid (CSF) culture.
  • Initial vancomycin treatment was ineffective, and the patient developed a coma and hydrocephalus despite antibiotic changes and surgery.

Findings:

  • Intrathecal vancomycin administration combined with lumbar drainage at L4-5 successfully reduced CSF cell counts.
  • This combined approach led to a gradual recovery of consciousness, indicating improved CSF circulation and infection control.

Implications:

  • This case suggests that lumbar drainage and intrathecal antibiotics may be crucial for refractory pneumococcal meningitis.
  • Such combined therapies can be life-saving in complex neurological infections unresponsive to standard treatments.

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