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[A case of vancomycin resistant Leuconostoc meningitis]
Ciğdem Ataman Hatipoğlu1, Eda Yildiz, Ender Köktekir
1SB Ankara Eğitim ve Araştirma Hastanesi, Enfeksiyon Hastaliklari ve Klinik Mikrobiyoloji Kliniği, Ankara. cigdemhatip@yahoo.com
Mikrobiyoloji Bulteni
|January 20, 2009
Summary
This case report details a rare instance of vancomycin-resistant Leuconostoc meningitis in a patient with subarachnoid hemorrhage. Prompt identification and linezolid treatment led to patient recovery, highlighting Leuconostoc as a potential pathogen.
Area of Science:
- Infectious Diseases
- Clinical Microbiology
- Neurology
Background:
- Leuconostoc species are infrequently pathogenic in humans.
- Serious infections, including meningitis, can rarely arise from Leuconostoc.
- Vancomycin resistance in Leuconostoc poses a significant clinical challenge.
Observation:
- A 57-year-old female developed nosocomial meningitis following subarachnoid hemorrhage treatment.
- Cerebrospinal fluid analysis revealed gram-positive cocci identified as vancomycin-resistant Leuconostoc spp.
- The patient presented with fever, confusion, and elevated CSF white blood cell count and protein levels.
Findings:
- The Leuconostoc isolate demonstrated resistance to vancomycin and teicoplanin but susceptibility to penicillin, ampicillin, cefotaxime, cefepime, chloramphenicol, clindamycin, erythromycin, and linezolid.
- Empirical treatment with ceftazidime and vancomycin was ineffective.
- Switching to linezolid resulted in clinical improvement after 14 days.
Implications:
- This case underscores the potential for Leuconostoc species to cause severe infections like meningitis.
- Lumbar punctures may represent a transmission route for nosocomial Leuconostoc infections.
- Vancomycin-resistant gram-positive cocci necessitate consideration of Leuconostoc in differential diagnoses.
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