A case of community-acquired pneumococcal meningitis following acute sinusitis and unsuccessful former antimicrobial therapy

Authors : Montaser M. Y Amro, Buket Baddal, Kaya Süer, Nurhak Demir

Pages : 75-80

Doi:10.34084/bshr.1278367

View : 161 | Download : 93

Publication Date : 2023-04-30

Article Type : Research Article

Abstract :Rapid diagnosis and treatment are critical for patient recovery in bacterial meningitis. Delayed initiation of antibiotic therapy is associated with increased in-hospital mortality and an unfavorable outcome at discharge. We report a 31-year-old female patient presenting with a history of acute sinusitis and cefuroxime medication for 7 days. On the 7th day, the patient was admitted to the emergency department with nausea, vomiting, confusion, headache, tendency to sleep. On physical examination, the patient presented with unresponsiveness and weak neck stiffness as a sign of meningeal irritation. Cerebrospinal fluid analysis revealed 13,446 leukocytes per mm3 with 95% neutrophils and 5% lymphocytes. CSF biochemical analysis indicated low CSF glucose (<1 mg/dL glucose), elevated CSF protein (476 mg/dL total protein) and >2000,00 mg/L albumin. CSF RT-qPCR was positive for Streptococcus pneumoniae. The patient was immediately administered ceftriaxone and vancomycin, and recovered without any neurological sequelae. This study highlights the importance of patient follow-up, accurate prognosis and rapid laboratory testing in patients with failed sinusitis treatment.
Keywords : Streptococcus pneumoniae, menenjit, sinüzit, başarısız tedavi, hızlı moleküler tanı