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Postoperative meningitis due to Pandoraea pnomenusa in a child with recurrent medulloblastoma: first CSF-proven case
Dr Naveen Kuriakose Thomas1, Dr Bcij Nanayakkara2, Dr Balaji Veeraraghavan3
1Christian Medical College Vellore, Department of Neurosciences / Neurological Sciences, India.
Abstract:
Pandoraea pnomenusa is an emerging non-fermenting Gram-negative bacillus most often described in cystic fibrosis and structural airway disease. CNS infection has not been documented previously. A 13-year-old boy with prior midline suboccipital craniectomy and chemoradiotherapy for classic medulloblastoma presented with obstructive hydrocephalus from recurrence. After emergency external ventricular drainage and gross total excision, he developed fever and meningeal signs on postoperative day 3. CSF culture yielded Pandoraea pnomenusa, confirmed by MALDI-TOF MS (99.9%). The isolate was resistant to meropenem and ciprofloxacin but susceptible to piperacillin-tazobactam, chloramphenicol and cotrimoxazole (MIC 0.12 μg/mL). Cotrimoxazole therapy led to resolution.
Insights
This study reports the first documented case of central nervous system (CNS) infection caused by Pandoraea pnomenusa in a pediatric medulloblastoma patient. Successful treatment with cotrimoxazole highlights a potential therapeutic option for this rare bacterial meningitis.
Area of Science:
- Neuroscience
- Infectious Diseases
- Microbiology
Background:
- Pandoraea pnomenusa is an emerging Gram-negative bacillus typically associated with respiratory conditions.
- Central nervous system (CNS) infections by this pathogen have not been previously documented.
- The case involves a 13-year-old male with recurrent medulloblastoma and obstructive hydrocephalus.
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