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[Stomatococcus mucilaginosus meningitis in immunocompromised child]
H Ben Salah1, F Crockaert, J Levy
1Unité d'hémato-oncologie, hôpital universitaire des enfants, Bruxelles, Belgique.
Summary
This case report details a rare instance of Stomatococcus mucilaginosus meningitis in a child undergoing chemotherapy. Combined intravenous and intrathecal vancomycin treatment proved effective in clearing the infection.
Area of Science:
- Infectious Diseases
- Pediatric Oncology
- Neuroscience
Background:
- Opportunistic infections pose significant risks for cancer patients with therapy-induced granulocytopenia.
- Stomatococcus mucilaginosus is an uncommon pathogen, rarely implicated in serious infections like meningitis.
Observation:
- A 2-year-old boy with neuroectodermal tumor developed fever and neutropenia during chemotherapy.
- He had a prior Stomatococcus mucilaginosus septicemia treated with vancomycin, with an indwelling catheter left in place.
- Meningitis due to Stomatococcus mucilaginosus developed despite initial antibiotic treatment.
Findings:
- The patient presented with severe aplasia (70 WBC/mm3) and subsequently developed Stomatococcus mucilaginosus meningitis.
- Treatment involved intravenous vancomycin and imipenem, followed by intrathecal vancomycin due to persistent infection.
- Cerebrospinal fluid cultures became negative after intrathecal vancomycin administration, leading to treatment cessation.
Implications:
- This case highlights the potential for Stomatococcus mucilaginosus to cause meningitis in immunocompromised pediatric patients.
- Combined intrathecal and systemic vancomycin therapy may be a viable treatment strategy for this rare condition.
- Management of indwelling catheters in neutropenic patients requires careful consideration to prevent opportunistic infections.