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[Bacteroides fragilis meningitis. 2 cases]
Abstract:
In this study based on 2 personal cases and 23 cases from the literature the main clinical and therapeutic features of meningitis caused by Bacteroides fragilis are reviewed. The disease occurs in either very young or elderly people, with contributing factors in 54% of the cases. Clinically, the infectious syndrome is associated with meningoencephalitis and sometimes motor disorders. Although septicaemia is present in 80% of the cases, the patient's general condition is moderately affected. Blood leucocyte counts are definitely increased and CSF disturbances are those common to all types of bacterial meningitis. The initial focus of infection can be determined in 60% of the cases. The mortality rate is higher in adults than in children. Neurological complications are frequent. Nitro-imidazole derivatives, which are active against Bacteroides fragilis and reach high CSF concentrations, constitute the treatment of choice.
Insights
Bacteroides fragilis meningitis primarily affects the very young or elderly, often linked to contributing factors. Nitro-imidazole derivatives are the recommended treatment due to their effectiveness and cerebrospinal fluid penetration.
Area of Science:
- Infectious Diseases
- Neurology
- Microbiology
Background:
- Review of clinical and therapeutic features of meningitis caused by Bacteroides fragilis.
- Analysis based on 2 personal cases and 23 literature cases.
Observation:
- Bacteroides fragilis meningitis predominantly affects the very young or elderly.
- Contributing factors are present in 54% of cases.
- Clinical presentation includes infectious syndrome, meningoencephalitis, and motor disorders.
Findings:
- Septicemia occurs in 80% of cases, yet general condition is moderately affected.
- Elevated blood leucocyte counts and typical bacterial meningitis CSF disturbances are observed.
- Initial infection focus identified in 60% of cases.
- Higher mortality rates in adults compared to children.
- Frequent neurological complications are noted.
Implications:
- Nitro-imidazole derivatives are the treatment of choice for Bacteroides fragilis meningitis.
- High cerebrospinal fluid concentrations of nitro-imidazoles are crucial for effective treatment.
- Understanding risk factors and clinical presentation aids in early diagnosis and management.