Simultaneous mixed bacterial meningitis in children

Herweg, John C.; Middelkamp, J. Neal; Hartmann, Alexis F.

doi:10.1016/s0022-3476(63)80305-4

Cited by 26 publications

(12 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Mixed bacterial meningitis is rare and occurs most frequently in young infants (Herweg, Middelkamp, and Hartmann, 1963). This case report of meningitis due to two organisms, Streptococcus pneumoniae and Mycobacterium tuberculosis, shows some of the diagnostic difficulties encountered and the importance of considering the possibility of a mixed infection.…”

Section: Mixed Pneumococcal and Tuberculous Meningitismentioning

confidence: 87%

Mixed pneumococcal and tuberculous meningitis.

Levinsky¹,

Wilkinson²

1974

Archives of Disease in Childhood

View full text Add to dashboard Cite

Section: Mixed Pneumococcal and Tuberculous Meningitismentioning

confidence: 87%

Mixed pneumococcal and tuberculous meningitis.

Levinsky¹,

Wilkinson²

1974

Archives of Disease in Childhood

View full text Add to dashboard Cite

“…These patients had minimal pleocytosis in the presence of positive CSF cultures and prolonged infection.They described a case of Salmonella meningitis in conjunction with the isolation of Echo 2 virus from the CSF. Salmonella meningitis in association with enterovirus as well as following instances of meningococcal meningitis have been described [6,23]. Reported CSF findings in both adults and children with S. typhi meningitis vary from predominantly lymphocytic to neutrophilic and from a minimal pleocytosis to frankly purulent, perhaps a reflection of time to presentation or prior use of antibiotics [24][25][26].…”

Section: Discussionmentioning

confidence: 99%

Salmonella Meningitis: Report of Three Cases in Adults and Literature Review

Karim

Islam

2002

Infection

View full text Add to dashboard Cite

Salmonella meningitis is an unusual complication of Salmonella sepsis and occurs almost exclusively in infants and young children. One case of Salmonella meningitis and two cases of cerebrospinal fluid (CSF) pleocytosis in adult patients with Salmonella bacteremia were studied and the literature was reviewed. On a retrospective review of the charts of 100 sequential patients with Salmonella typhi and S. paratyphi-positive blood cultures, we found one patient with fulminant Salmonella meningitis and two others with CSF pleocytosis. All three patients survived. The patient with Salmonella meningitis had significant residual neurologic sequela. Salmonella encephalopathy occurred in six other patients who presented with headache and were confused or drowsy. Cases of meningitis in adults do occur and are associated with a high morbidity and mortality. Newer cephalosporn antibiotics may be the therapy of choice in these infections.

show abstract

“…Simultaneous mixed meningitis has been reported since the early 1900s and implies that two or more bacterial species are isolated on culture of the patient's initial CSF specimen (8). Two main categories of mixed bacterial meningitis (MBM) could be distinguished: community-acquired MBM involving common pathogens (like S. pneumoniae, N. meningitidis, H. influenzae and Branhamella catarrhalis) that are mainly observed in infants and were more frequently reported before 1950 (13) and hospital-acquired MBM involving mainly gram-negative bacilli.…”

Section: Case Reportmentioning

confidence: 99%

“…Some MBM cases implicated S. pneumoniae or N. meningitidis (Table 1), but the association of these two common meningitis agents has rarely been reported for simultaneous infection of the meninges. The last case of MBM involving simultaneous culture of S. pneumoniae, formerly Diplococcus pneumoniae, and N. meningitidis from a CSF sample was reported in 1963 (8). In the case of MBM, the identification of one microorganism may well jeopardize diagnosis of the second, particularly when the mixed culture includes both a grampositive and a gram-negative bacterium.…”

Section: Case Reportmentioning

confidence: 99%

“…Few data and fewer recent data on MBM in children are available. In 1963, Herweg et al reported a 3.75% rate of MBM in reviewing 534 cases of acute bacterial meningitis (8), suggesting that MBM is not so uncommon in children. In this series (n ϭ 20), MBM was associated with poor diagnosis, as only 35% of the patients recovered completely without sequelae.…”

Section: Case Reportmentioning

confidence: 99%

See 1 more Smart Citation

Mixed Bacterial Meningitis Due to Streptococcus pneumoniae and Neisseria meningitidis in an 18-Month-Old Child

Marchandin¹,

Ventura

Alonso

et al. 2005

J Clin Microbiol

View full text Add to dashboard Cite

We report an unusual case of culture-proven pneumococcal and meningococcal mixed meningitis in an 18-month-old girl. The patient responded well to antimicrobial therapy and recovered completely without sequelae. No underlying condition could be demonstrated except a rhinitis of unknown etiology 2 days before the onset of the symptoms suggesting meningitis. CASE REPORTAn 18-month-old girl was admitted to the emergency unit of the Montpellier Teaching Hospital in November 2003 for deteriorating general condition in the previous 48 h, with fever at 40°C, asthenia, and vomiting in a context of rhinitis. She had no previous medical history. On admission, she was lethargic and algetic but had no identified hemodynamic dysfunction. Physical examination revealed clear meningeal syndrome with stiff neck and Kernig and Brudzinsky signs. No focal signs or purpura were observed. She presented with pharyngitis, bilateral serous mucosal otitis, and cervical adenopathy of less than 1 cm. Laboratory evaluation revealed a C-reactive protein value of 170.5 mg/liter and a white blood cell count of 16,500/mm 3 . Lumbar puncture revealed turbid cerebrospinal fluid (CSF) with a white cell count of 750 cells/mm 3 with 83% polymorphonuclear leukocytes. Gram staining of CSF revealed very rare gram-positive diplococci. A latex particle agglutination test for the detection of bacterial antigen was done on the CSF with Wellcogen tests (Remel, Dartford, United Kingdom) and was negative for serogroup B Neisseria meningitidis, Escherichia coli K1, Streptococcus pneumoniae, Haemophilus influenzae b, and N. meningitidis serogroups A, C, Y, and W135. CSF parameters were as follows: glucose level of 2.6 mmol/liter, with serum glucose level of 16.6 mmol/liter and protein level of 1.14 g/liter. Based on these first results, and given the possibility of decreased susceptibility to penicillin of the presumed microorganism, empirical therapy, consisting of intravenous cefotaxime (300 mg/kg of body weight/day) and vancomycin (60 mg/kg/ day), was started. The CSF sample was cultured on Trypticase soy agar, Trypticase soy broth, Schaedler broth with vitamin K3 and 0.2% agar (bioMérieux, Marcy l'Etoile, France), and bloodchocolate agar incubated at 37°C in a 5% CO 2 atmosphere. Detection of microorganisms by PCR was not performed on this CSF sample. After 24 h of incubation, cultures of CSF yielded mixed growth of catalase-negative, gram-positive cocci and oxidase-positive, gram-negative diplococci. The two organisms were further identified as S. pneumoniae and N. meningitidis, respectively. The S. pneumoniae isolate was presumptively identified on the basis of the observation of an 18-mm-diameter inhibition zone around a 5-g optochin disk (Becton Dickinson, Sparks, Mass.) after incubation in an atmosphere of increased CO 2 . This identification was confirmed by using a DNA probe, the Accuprobe Streptococcus pneumoniae culture identification test (Gen-Probe; bioMérieux), according to the manufacturer's instructions. S. pneumoniae was shown to belong to se...

show abstract

Simultaneous mixed bacterial meningitis in children

Cited by 26 publications

References 17 publications

Mixed pneumococcal and tuberculous meningitis.

Mixed pneumococcal and tuberculous meningitis.

Salmonella Meningitis: Report of Three Cases in Adults and Literature Review

Mixed Bacterial Meningitis Due to Streptococcus pneumoniae and Neisseria meningitidis in an 18-Month-Old Child

Contact Info

Product

Resources

About