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[An adult case of bacterial meningitis caused by penicillin-resistant Streptococcus pneumoniae]
M Yamawaki1, J Shiraishi, N Sanjo
1Department of Neurology, Tokyo Medical and Dental University.
Abstract:
Recently the incidence of infectious diseases caused by penicillin-resistant Streptococcus pneumoniae (PRSP) is increasing. Patients with meningitis caused by PRSP have been reported with high mortality especially in the field of pediatrics, and it is crucial to treat with accurate and precise choice of antibiotics. We report the first adult case of bacterial meningitis caused by PRSP in Japan. A 32-year-old male without immunological abnormalities developed acute pneumococcal meningitis. Empiric therapy with ampicillin and cefotaxime was not effective and the S. pneumonia from CSF showed resistance to multiple antibiotics such as penicillin and cefotaxime. He was treated successfully with the combination of panipenem/betamipron, vancomycin, and chloramphenicol. We assume that panipenem/betamipron is recommended to be added to empiric therapy of bacterial meningitis, considering an increasing incidence of PRSP infection.
Insights
Penicillin-resistant Streptococcus pneumoniae (PRSP) meningitis is increasing. This case highlights successful treatment with panipenem/betamipron, vancomycin, and chloramphenicol in an adult, suggesting its addition to empiric therapy.
Area of Science:
- Infectious Diseases
- Microbiology
- Neurology
Background:
- Increasing incidence of penicillin-resistant Streptococcus pneumoniae (PRSP) infections.
- High mortality associated with PRSP meningitis, particularly in pediatric cases.
- Need for effective antibiotic strategies against drug-resistant bacterial meningitis.