minocycline and Meningitis

Topics: Ampicillin; Bacterial Infections; Brain Edema; Child, Preschool; Chloramphenicol; Cloxacillin; Gentamicins; Haemophilus influenzae; Humans; Infant; Infant, Newborn; Injections, Spinal; Meningitis; Meningitis, Haemophilus; Meningitis, Meningococcal; Meningitis, Pneumococcal; Methicillin; Minocycline; Neisseria meningitidis; Penicillin G; Rifampin; Seizures; Shock; Streptococcus pneumoniae; Sulfonamides

Tigecycline is a broad-spectrum antibiotic with activity against multidrug-resistant (MDR) bacteria. It has limited indications. Studies are necessary to elaborate new guidelines. Here we report a case of postoperative MDR Acinetobacter baumannii meningitis treated by tigecycline combined with colimycin for 21 days. The treatment was well tolerated with a favourable outcome. In conclusion, tigecycline was shown to be effective in a case of MDR A. baumannii meningitis.

Topics: Acinetobacter baumannii; Acinetobacter Infections; Adult; Anti-Bacterial Agents; Colistin; Drug Resistance, Multiple, Bacterial; Humans; Male; Meningitis; Microbial Sensitivity Tests; Minocycline; Tigecycline

A 70-year-old man had hyperemia of the right cornea associated with a high serum C-reactive protein value. MRI of the head revealed hypertrophic pachymeningitis associated with a mass in the right cavernous sinus. The hypertrophic dura showed iso-intensity on T1 -weighted image, and very low intensity on T2-weighted image, and was markedly enhanced with gadolinium. In contrast, the mass in the right cavernous sinus was only slightly enhanced. Intravenous administration of some antibiotics (piperacillin sodium, ampicillin sodium/ sulbactam sodium, ampicillin sodium, cefozopran hydrochloride) was begun, but minocycline hydrochloride, which was subsequently administrated, proved remarkably effective in relieving symptoms and decreasing the serum C-reactive protein value, although other antibiotics showed little or no effect. MRI performed 9 days after initiation of minocycline therapy showed remarkable relief from hypertrophy of the dura compared with a scan obtained before admission. Although hypertrophic pachymeningitis in this case may have been associated with infection by bacteria that were especially sensitive to minocycline, the drug is believed to have anti-inflammatory and immunosuppressive effects similar to those of steroids used to relieve the symptoms of rheumatoid arthritis or Takayasu arteritis. We suspect that hypertrophic pachymeningitis in this patient may have been idiopathic or associated with an autoimmune disease, and may therefore have been relieved by the anti-inflammatory and immunosuppressive effects of minocycline in a manner similar to the Seffect of steroids on similar types of hypertrophic pachymeningitis.

Topics: Aged; Anti-Bacterial Agents; Anti-Inflammatory Agents; C-Reactive Protein; Humans; Immunosuppressive Agents; Magnetic Resonance Imaging; Male; Meningitis; Minocycline

Eosinophilic meningitis has been defined as meningitis in which a total cerebrospinal fluid (CSF) sample is found to have more than 10 eosinophils per millimeter or is composed of greater than 10% eosinophils. The differential diagnosis is broad and the clinical presentation, lacking an internalized CSF diversion system, is often nonspecific. With respect to patients with shunt systems, a positive correlation exists between CSF eosinophilia and eventual shunt failure requiring revision. In this paper the authors present the highest reported level of CSF eosinophilia in conjunction with a rifampin and minocycline-impregnated ventriculostomy catheter recently approved by the Food and Drug Administration.

Topics: Adolescent; Anti-Bacterial Agents; Antibiotics, Antitubercular; Catheterization; Diagnosis, Differential; Eosinophilia; Humans; Male; Meningitis; Minocycline; Rifampin; Ventriculostomy

Topics: Benzamidines; Disseminated Intravascular Coagulation; Guanidines; Humans; Hydrocortisone; Male; Meningitis; Middle Aged; Minocycline; Pulmonary Fibrosis; Scrub Typhus

Four cases of postoperative meningitis caused by methicillin-resistant Staphylococcus aureus (MRSA) are reported together with a review of the literature. These 4 cases were treated successfully by intravenous administration of minomycin, fosfomycin, and cefmetazole. Factors associated with the development of meningitis included multiple craniotomies, the presence of ventricular drainage or a ventriculo-peritoneal shunt, and irradiation.

Topics: Adult; Cefmetazole; Drug Therapy, Combination; Fosfomycin; Humans; Injections, Intravenous; Male; Meningitis; Methicillin Resistance; Middle Aged; Minocycline; Postoperative Complications; Staphylococcal Infections; Staphylococcus aureus

A 14-year-old boy was admitted to our hospital complaining of dull headache, high fever and decreased visual acuity of his left eye. Physical examination on admission revealed nuchal rigidity, positive Kernig's sign, slight hyperreflexia of deep tendon reflex, and decreased visual acuity of his left eye to 0.1. The chest was clear to percussion and auscultation, and no abnormal findings was observed on chest x-ray examination. On laboratory examination, leukocytosis (12,800/mm3) and increased erythrocyte sedimentation rate (83mm/hr) was observed. Cerebrospinal fluid (CSF) examination showed pleocytosis (308/3, mono 286, poly 22) and slight elevation of protein without decrease of glucose content (52mg/dl). On ophthalmologic examination, characteristic anterior and posterior uveitis was found in both eyes, more on the left. Antibody titer to psittaci was significantly elevated in both serum and CSF in his clinical course, therefore, this case was diagnosed as psittacosis meningitis complicated with uveitis. Minocycline (200mg/day) was administered from the 30th hospital day. The effect of this drug was dramatic, and fever and dull headache rapidly disappeared. In addition, fundus oculi examination on the 85th hospital day, revealed no abnormality in his eyes, and his visual acuity returned to normal level (1.0). This case was considered to be extremely rare case of psittacosis, because in addition to meningitis, the patient complicated with uveitis without any respiratory signs and symptoms.

Topics: Adolescent; Humans; Male; Meningitis; Meningitis, Aseptic; Minocycline; Psittacosis; Uveitis