Meningitis caused by vancomycin-resistant Leuconostoc sp

Abstract

A rare case of purulent meningitis caused by vancomycin-resistant Leuconostoc sp. is reported. The patient was treated successfully with penicillin G, and there were no neurological sequelae. We recommend that all gram-positive cocci isolated from cerebrospinal fluid and blood be fully identified so as not to confuse Leuconostoc spp. with more commonly isolated pathogens such as pneumococci and other alpha-hemolytic streptococci.

OSTEOMYELITIS CAUSED BY LEUCONOSTOC SPECIES

“…Bacteremia is the most common Leuconostoc infection with other infections including pneumonia, meningitis, infected peritoneal dialysis fluid and ondotogenic abscess 2 –6 . This is the first case of Leuconostoc osteomyelitis in any patient.…”

“…A degree of host defense impairment is one of the most important predisposing factors 2 . Being immunocompromised is not, however, an essential feature as indicated by a case report of Leuconostoc purulent meningitis in a previously healthy 16‐year‐old 3 …”

Leuconostoc Species—Associated Endocarditis

“…2,3 However, since the isolation of Leuconostoc species from the blood cultures of two immunocompromised patients in 1985, 4 several occurrences of Leuconostoc infections have been reported. [5][6][7][8][9][10][11][12][13][14][15] These infections affected both immunocompetent and immunocompromised patients and included bacteremia, urinary tract infections, meningitis, spontaneous bacterial peritonitis, and endocarditis.…”

“…8,14 Like our patient, however, there are reports of Leuconostoc infections in patients who had no significant medical histories or risk factors. 5,9 With the discovery of Leuconostoc pathogenicity, several reports have concurred that these bacteria are not readily identified in the laboratory and that they frequently demonstrate high-level resistance to vancomycin while preserving sensitivity to most other antibacterial agents. 2,4,6,[16][17][18] Our patient' s particular case of Leuconostoc species-associated endocarditis is unusual in that the Leuconostoc pathogen identified was vancomycin sensitive.…”

Lactic acid bacteria and human clinical infection

“…1990). There are two reports of generalized infections in apparently immunocompetent hosts (Coovadia et al 1987;Wenocur et al 1988). Many of the reported cases of leuconostoc bacteraemia occurred in neonates, in most of whom the source of infection remained unclear.…”