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Bacteroides fragilis meningitis
1Department of Pediatrics, University of Connecticut Health Center, Farmington 06032.
Abstract:
Bacteroides fragilis is a rare cause of bacterial meningitis. In the antibiotic era nine cases have been reported. Seven of these nine cases occurred in premature infants and neonates. Of the nine patients with B. fragilis meningitis, two died, four survived with neurologic sequelae, and three survived without sequelae. Predisposing conditions included abdominal sepsis, chronic otitis media, and ventriculoatrial shunt infection. Metronidazole, which is bactericidal, has been the most effective therapy for B. fragilis meningitis.
Insights
Bacteroides fragilis meningitis is rare, primarily affecting premature infants. Metronidazole shows effectiveness in treating this serious bacterial infection, though outcomes vary.
Area of Science:
- Microbiology
- Infectious Diseases
- Neonatal Care
Background:
- Bacteroides fragilis, an anaerobic bacterium, is an uncommon pathogen in bacterial meningitis.
- Meningitis cases caused by B. fragilis are infrequently reported, especially within the antibiotic era.
Observation:
- Seven of the nine reported cases of B. fragilis meningitis occurred in premature infants and neonates.
- Predisposing factors identified include abdominal sepsis, chronic otitis media, and ventriculoatrial shunt infections.
Findings:
- Outcomes for B. fragilis meningitis patients were severe: two deaths, four survivors with neurologic sequelae, and three without sequelae.
- Metronidazole, a bactericidal antibiotic, demonstrated the most effective therapeutic response.
Implications:
- Highlights the importance of considering B. fragilis in neonatal meningitis, particularly with predisposing conditions.
- Emphasizes metronidazole as a key treatment option for B. fragilis meningitis, guiding clinical management.
- Underscores the significant morbidity and mortality associated with this rare but serious infection.