rifampin and Mastoiditis

Meningitis is a rare clinical manifestation of invasive group A streptococcal (iGAS) disease. Clinical, microbiological and molecular characteristics of 6 consecutive cases of GAS meningitis treated in Haukeland University Hospital in the period 2004-2009 are described. All 6 patients had a primary upper respiratory tract infection, with subsequent mastoiditis in 5, subdural effusions in 2, and cerebral abscess in 1. Five patients needed surgical treatment (myringotomy, craniotomy or mastoidectomy). All patients were treated with a beta-lactam antibiotic in combination with rifampicin. The course was complicated in all cases, and 1 patient died. Three of the bacterial isolates were of the sequence type emm1.0 and they shared the same superantigen gene profile (speA, speG, speJ, smeZ). The remaining 3 isolates belonged to sequence types emm 3.1, emm6.4 and emm12.0. Deletions in emm genes were observed. This report describes the severe and complicated course of GAS meningitis and its management, often requiring surgical intervention.

Topics: Adolescent; Aged; Anti-Bacterial Agents; Antigens, Bacterial; Bacterial Outer Membrane Proteins; beta-Lactams; Carrier Proteins; Child; Female; Gene Deletion; Humans; Male; Mastoiditis; Meningitis, Bacterial; Microbial Sensitivity Tests; Middle Aged; Norway; Rifampin; Streptococcal Infections; Streptococcus pyogenes; Superantigens

Some members of the Non-Tuberculous Mycobacteria family are free living organisms in the environment. They may be pathogenic in the immunocomprimised or in chronic lung disease. We describe a case of a nine year old of Asian descent who presented with clinical mastoiditis where the pathogenic organism was Mycobacterium Gordonae. The decision was made to give the patient full antimycobacterial treatment and subsequently the patient made a full recovery.

Topics: Antibiotics, Antitubercular; Antitubercular Agents; Child; Ethambutol; Female; Humans; Ireland; Isoniazid; Mastoiditis; Nontuberculous Mycobacteria; Pyrazinamide; Rifampin

Topics: Acquired Immunodeficiency Syndrome; Adult; AIDS-Related Opportunistic Infections; Anti-Bacterial Agents; Antibiotics, Antitubercular; Drainage; Erythromycin; Humans; Male; Mastoiditis; Rhodococcus equi; Rifampin