Korean J Clin Microbiol.
2009 Jun;12(2):92-96. 10.5145/KJCM.2009.12.2.92.
A Case of Streptococcus salivarius Meningitis in a Patient with Cerebrospinal Fluid Rhinorrhea after Skull Base Fracture
- Affiliations
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- 1Department of Laboratory Medicine, Chungbuk National University College of Medicine, Cheongju, Korea. ksshin@chungbuk.ac.kr
- 2Department of Neurology, Chungbuk National University College of Medicine, Cheongju, Korea.
- 3Department of Otorhinolaryngology-Head and Neck Surgery, Chungbuk National University College of Medicine,Cheongju, Korea.
- 4Department of Neurosurgery, Chungbuk National University College of Medicine, Cheongju, Korea.
- 5Department of Radiology, Chungbuk National University College of Medicine, Cheongju, Korea.
- 6Department of Surgery, Chungbuk National University College of Medicine, Cheongju, Korea.
- 7Department of Pathology, Chungbuk National University Hospital, Cheongju, Korea.
- KMID: 1469960
- DOI: http://doi.org/10.5145/KJCM.2009.12.2.92
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.
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