Neisseria meningitidis subdural empyema causing acute cauda equina syndrome

Blood and CSF cultures were positive for Neisseria meningitidis serogroup B. He received empirical bacterial meningitis therapy on presentation to the hospital as per local guidelines with 4 g ceftriaxone every 24 h, vancomycin titrated to >20 mg/L and 10 mg dexamethasone every 6 h, and 1·8 g ben...

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Bibliographic Details
Published in:The Lancet infectious diseases 2017-07, Vol.17 (7), p.780-780
Main Authors: Smibert, Olivia C, Vujovic, Olga, Hoy, Jennifer
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents - therapeutic use
Bacteria
Benzylpenicillin
Catheters
Cauda Equina Syndrome
Ceftriaxone
Ceftriaxone - therapeutic use
Cerebrospinal fluid
Dexamethasone
Dexamethasone - therapeutic use
Empyema
Empyema, Subdural - complications
Empyema, Subdural - diagnostic imaging
Empyema, Subdural - drug therapy
Empyema, Subdural - microbiology
Evacuations & rescues
Fecal incontinence
Humans
Infectious diseases
Intensive care
Magnetic Resonance Imaging
Male
Meningitis
Meningitis, Meningococcal - complications
Meningitis, Meningococcal - diagnostic imaging
Meningitis, Meningococcal - drug therapy
Meningitis, Meningococcal - microbiology
Neisseria meningitidis - drug effects
Neisseria meningitidis - pathogenicity
Neisseria meningitidis - physiology
Penicillin G - therapeutic use
Polyradiculopathy - diagnostic imaging
Polyradiculopathy - etiology
Polyradiculopathy - microbiology
Polyradiculopathy - surgery
Serogroup
Spinal cord
Subdural empyema
Vancomycin
Vancomycin - therapeutic use
Young Adult
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Description
Summary:Blood and CSF cultures were positive for Neisseria meningitidis serogroup B. He received empirical bacterial meningitis therapy on presentation to the hospital as per local guidelines with 4 g ceftriaxone every 24 h, vancomycin titrated to >20 mg/L and 10 mg dexamethasone every 6 h, and 1·8 g benzylpenicillin every 4 h. On day 2 after admission, after bacterial identification of N meningitidis, treatment was simplified to the use of high dose ceftriaxone monotherapy. Subdural...
ISSN:1473-3099
1474-4457
DOI:10.1016/S1473-3099(17)30343-2