meropenem and Otitis-Media

Fusobacterium necrophorum, an anaerobic, gram-negative rod, belongs to the physiological flora of the oropharynx. It causes Lemierre's syndrome characterized by oropharyngeal infection, septic thrombophlebitis of the neck, in particular of the internal jugular vein, and metastatic abscesses, predominantly in the lungs. Rarely, and mainly in children, it causes meningitis. Here we report the clinical course of a 25-year-old woman with F. necrophorum meningitis. She presented with incomplete, right third nerve palsy. Within a few days, she developed fever, meningism and progressive reduction of vigilance. Cerebrospinal fluid analysis showed typical signs of bacterial meningitis. After the identification of F. necrophorum, the antibiotic treatment was changed to meropenem, which led to continuous improvement of the clinical symptoms. Due to persistent signs of inflammation in the CSF, metronidazole was added to the antibiotic regime. This case report demonstrates that F. necrophorum should always be considered in the diagnostic workup of bacterial meningitis in adults.

Topics: Adult; Anti-Bacterial Agents; Blood Glucose; Cerebrospinal Fluid Proteins; Diagnosis, Differential; Drug Therapy, Combination; Female; Fusobacterium necrophorum; Humans; Lactic Acid; Leukocyte Count; Lung Abscess; Meningitis, Bacterial; Meropenem; Metronidazole; Oculomotor Nerve Diseases; Otitis Media; Pharyngitis; Sepsis; Syndrome; Thienamycins

Shewanella putrefaciens is a facultatively anaerobic, non-motile, Gram-negative, non-fermentative bacterium. It is found in various environments and has been isolated worldwide. S. putrefaciens is a rare cause of brain abscesses and meningitis. This is a case report of a cerebellar abscess and meningitis caused by Shewanella putrefaciens and Klebsiella pneumoniae in a river trap fisherman.

Topics: Adult; Brain Abscess; Cerebellar Diseases; Gram-Negative Bacterial Infections; Head; Humans; Klebsiella Infections; Klebsiella pneumoniae; Male; Meningitis, Bacterial; Meropenem; Otitis Media; Radiography; Shewanella putrefaciens; Thienamycins

Topics: Acute Disease; Anti-Bacterial Agents; Anti-Inflammatory Agents; Bacteremia; Cerebrospinal Fluid; Clarithromycin; Dexamethasone; Drug Therapy, Combination; Female; Humans; Infant; Infusions, Intravenous; Meningitis, Pneumococcal; Meropenem; Microbial Sensitivity Tests; Otitis Media; Streptococcus pneumoniae; Thienamycins