A Case of Streptococcus salivarius Meningitis in a Patient with Cerebrospinal Fluid Rhinorrhea after Skull Base Fracture.
10.5145/KJCM.2009.12.2.92
- Author:
Kyeong Seob SHIN
1
;
Dong Ik SHIN
;
Woo Sub SHIM
;
Byeong Cheol RIM
;
Il Hun BAE
;
Seung Young LEE
;
Dong Hee RYU
;
Eun Jung KIM
;
Bo Ra SON
Author Information
1. Department of Laboratory Medicine, Chungbuk National University College of Medicine, Cheongju, Korea. ksshin@chungbuk.ac.kr
- Publication Type:Case Report
- Keywords:
Streptococcus salivarius;
Meningitis;
Skull fracture;
Basilar
- MeSH:
Anesthesia, Spinal;
Cefotaxime;
Ceftriaxone;
Cerebrospinal Fluid Rhinorrhea;
Emergencies;
Gram-Positive Cocci;
Humans;
Korea;
Leukocytosis;
Meningitis;
Meningitis, Bacterial;
Neutrophils;
Penicillins;
Skull;
Skull Base;
Skull Fractures;
Spinal Puncture;
Streptococcus;
Vancomycin;
Young Adult
- From:Korean Journal of Clinical Microbiology
2009;12(2):92-96
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Streptococcus salivarius meningitis is very uncommon, and most cases are iatrogenic, occurring after invasive procedures such as spinal anesthesia or lumbar puncture etc.. Post-traumatic occurrence of this infection is especially rare. A 20-year-old man with a previous history of skull base fracture was seen at the emergency department with signs of acute bacterial meningitis. The CSF had a few gram positive cocci with neutrophilic pleocytosis, which were identified as S. salivarius by the Vitek system (bioMerioux, Inc., Hazelwood, MO, USA), rapid ID 32 Strep (bioMerieux, Marcy-l'Etoile, France) and 16S rRNA sequencing. The microorganism showed intermediate resistance to penicillin (MIC=0.25 microg/mL) but was susceptible to cefotaxime (MIC=0.25 microg/mL) and vancomycin (MIC= 0.75 microg/mL). The patient was treated with ceftriaxone and vancomycin. He also had his CSF leakage repaired by an endoscopic approach. To our knowledge, this is the first case of S. salivarius meningitis reported in Korea.
