Related Experiment Videos
Meningitis caused by Oerskovia xanthineolytica
E J Kailath1, E Goldstein, F H Wagner
1Department of Internal Medicine, School of Medicine, University of California, Davis.
The American Journal of the Medical Sciences
|March 1, 1988
Summary
A central nervous system infection caused by O. xanthineolytica, likely originating from a ventricular shunt, led to smoldering meningitis. Surgical removal of the shunt alongside antibiotic treatment successfully cured the infection.
Area of Science:
- Infectious Diseases
- Neuroscience
- Microbiology
Background:
- Ventricular shunts are crucial for managing cerebrospinal fluid (CSF) disorders but can be a nidus for infection.
- Central nervous system (CNS) infections pose significant diagnostic and therapeutic challenges.
Observation:
- A case of smoldering meningitis caused by Ochrobactrum xanthineolytica (O. xanthineolytica) is presented.
- The infection was likely introduced via a contaminated ventricular shunt.
- The meningitis exhibited resistance to standard antibiotic regimens, including penicillin and rifampin, despite in vitro susceptibility.
Findings:
- Inadequate penetration of penicillin into the cerebrospinal fluid was presumed to be a factor in treatment failure.
- The difficulty of eradicating bacteria colonizing shunt hardware complicates treatment.
- Combined surgical removal of the infected shunt and continued antibiotic therapy led to a complete cure.
Implications:
- This case highlights the importance of considering shunt-associated infections in CNS meningitis.
- It underscores the challenges in treating infections involving foreign bodies in the CNS.
- Successful management may require a multimodal approach, including device removal and targeted antimicrobial therapy.