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Meningitis caused by Acinetobacter calcoaceticus var anitratus. A specific hazard in neurosurgical patients
Abstract:
Acinetobacter calcoaceticus var anitratus caused meningitis in five patients between 1968 and 1978 at two hospitals affiliated with Boston University School of Medicine. All patients had had head trauma or neurosurgical procedures prior to the development of meningitis. The course of the disease was relatively indolent in that fulminant disease did not occur even when initial therapy was inappropriate and bacteria persisted in CSF. All five patients survived. On Gram's stain of CSF, A calcoaceticus may be confused with meningococci, pneumococci, or Haemophilus influenzae and thus cause delay in appropriate diagnosis and therapy.
Insights
Acinetobacter calcoaceticus meningitis, often following head trauma, presented indolently in five patients. Despite initial misdiagnosis and persistent bacteria, all patients survived, highlighting diagnostic challenges.
Area of Science:
- Infectious Diseases
- Neuroscience
- Medical Microbiology
Background:
- Acinetobacter calcoaceticus is an opportunistic pathogen.
- Meningitis is a serious infection of the membranes surrounding the brain and spinal cord.
Observation:
- Five cases of meningitis caused by Acinetobacter calcoaceticus var anitratus were identified between 1968 and 1978.
- All patients had a history of head trauma or neurosurgical procedures.
- The clinical course was generally indolent, with no fulminant disease observed.
Findings:
- Acinetobacter calcoaceticus meningitis can present with a slow-progressing course, even with inappropriate initial therapy.
- Bacteria persisted in cerebrospinal fluid (CSF) in some cases.
- All five patients survived the infection.
Implications:
- Acinetobacter calcoaceticus should be considered in meningitis cases, especially after head trauma or neurosurgery.
- Gram stain of CSF can lead to misidentification of Acinetobacter calcoaceticus, potentially delaying appropriate treatment.
- Prompt and accurate diagnosis is crucial for effective management of Acinetobacter calcoaceticus meningitis.