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Community-acquired Serratia marcescens meningitis
A Peeters1, B Vandercam, C J Sindic
1Department of Neurology, St-Luc University Hospital, Brussels, Belgium.
The Journal of Infection
|February 12, 1998
Summary
Serratia marcescens meningitis is rare in adults, especially after head injury. Antibiotic treatment for cerebrospinal fluid (CSF) leaks can lead to difficult-to-treat Gram-negative meningitis.
Area of Science:
- Neuroscience
- Infectious Diseases
Background:
- Serratia marcescens is an uncommon cause of community-acquired meningitis in adults.
- Cerebrospinal fluid (CSF) leaks, particularly following head trauma, represent a potential pathway for infection.
Observation:
- A case of S. marcescens meningitis is presented, occurring 29 years post-head injury.
- The patient experienced 3 years of intermittent clear nasal discharge (CSF leak) prior to meningitis.
- The patient had received cefadroxil treatment one month before admission.
Findings:
- This case highlights the risk of Gram-negative bacillary meningitis in individuals with CSF leaks treated with antibiotics.
- Antibiotic therapy in the presence of a fistula can select for resistant organisms, complicating treatment.
Implications:
- Patients with chronic clear nasal discharge should be evaluated for a history of head injury before antibiotic prescription.
- Surgical repair of CSF fistulae is crucial due to the high risk of meningitis and the low likelihood of spontaneous closure.