Meningitis in a patient with neutropenia due to Rothia mucilaginosa: a case report

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Maxim Clauwaert1, Patrick Druwé2, Pieter Depuydt2

  • 1Intensive Care Unit, Universitair Ziekenhuis Gent, C. Heymanslaan 10, 9000, Ghent, Belgium. maxim.clauwaert@ugent.be.

Journal of Medical Case Reports
|March 13, 2019
PubMed
Abstract

Insights

Rothia mucilaginosa can cause fatal meningitis in neutropenic patients. Early empirical treatment with amoxicillin/rifampicin is suggested, with potential for intrathecal antibiotics if needed.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Hematology

Background:

  • Rothia mucilaginosa, a Gram-positive bacterium, is a common oral and respiratory commensal.
  • It rarely causes disease in immunocompetent individuals but can lead to severe opportunistic infections in immunocompromised hosts.

Observation:

  • A case of a 67-year-old woman with acute myeloid leukemia developed Rothia mucilaginosa meningitis during neutropenic treatment.
  • Symptoms included fever, headaches, and photophobia, with cerebrospinal fluid cultures confirming the infection.

Findings:

  • The patient succumbed to refractory intracranial hypertension despite comprehensive treatment.
  • This case highlights the potential lethality of Rothia mucilaginosa meningitis in neutropenic patients.

Implications:

  • There is a lack of evidence-based guidelines for treating Rothia mucilaginosa meningitis.
  • Empirical therapy with amoxicillin/rifampicin is proposed, with consideration for intrathecal antibiotics in severe cases with neurosurgical access.
Keywords:
Acute myeloid leukemiaMeningitisNeutropeniaRothia mucilaginosa

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