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Related Experiment Videos

Relapsing bacterial meningitis in adults

L M Tang1, S T Chen

  • 1Department of Neurology, Chang Gung Memorial Hospital and Medical College, Taipei, Taiwan.

QJM : Monthly Journal of the Association of Physicians
|August 1, 1994
PubMed
Summary

Relapsing bacterial meningitis is rare, often involving Gram-negative bacilli in neurosurgical patients. Extended antibiotic treatment is crucial, as normal cerebrospinal fluid tests don't prevent relapse.

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Area of Science:

  • Infectious Diseases
  • Neurology
  • Microbiology

Background:

  • Relapsing bacterial meningitis is an uncommon but serious condition.
  • This study investigates its occurrence and characteristics in adult patients.

Observation:

  • Eight cases were identified at our institution between 1981-1993, representing 3.4% of adult bacterial meningitis cases.
  • A literature review identified five additional adult cases.
  • The total cohort comprised 13 patients (9 female, 4 male), aged 17-61, with 10 having neurosurgical histories.

Findings:

  • Gram-negative bacilli, particularly Klebsiella species, were the most frequent pathogens in both initial and relapsed infections.
  • Three patients succumbed to the infection during relapse.
  • Extended antibiotic therapy (≥4 weeks) may be necessary for post-surgical Gram-negative bacillary meningitis.

Implications:

  • A normal cerebrospinal fluid result post-treatment does not preclude meningitis relapse.
  • This highlights the need for vigilant monitoring and potentially prolonged treatment strategies for specific meningitis cases.

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