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Meningitis due to penicillin resistant Streptococcus pneumoniae occurring in a patient on long term ampicillin

P R Chadwick1, M G Keaney, R A Jones

  • 1Department of Microbiology, Hope Hospital, Salford, U.K.

The Journal of Infection
|November 1, 1993
PubMed

Insights

A patient developed recurrent meningitis due to penicillin-resistant Streptococcus pneumoniae despite antibiotic prophylaxis. This case highlights challenges in managing dural fistulas and antibiotic resistance.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Microbiology

Background:

  • Persistent dural fistulas can lead to recurrent bacterial meningitis.
  • Cerebrospinal fluid (CSF) rhinorrhoea is a significant risk factor for meningitis.
  • Antibiotic prophylaxis is often used in patients with recurrent meningitis.

Observation:

  • A patient with a history of recurrent meningitis and CSF rhinorrhoea presented with a new meningitis episode.
  • The causative agent was identified as a penicillin-resistant strain of Streptococcus pneumoniae.
  • The patient was on prophylactic ampicillin at the time of infection.

Findings:

  • The prophylactic ampicillin failed to prevent meningitis caused by the resistant pathogen.
  • This underscores the emergence of antibiotic resistance in Streptococcus pneumoniae.
  • Microbiological management strategies are crucial for successful treatment.

Implications:

  • This case highlights the limitations of antibiotic prophylaxis in the face of emerging resistance.
  • Effective management requires a thorough understanding of both the underlying fistula and the causative microorganisms.
  • Further research into novel therapeutic approaches for meningitis in patients with dural defects is warranted.

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