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KMID : 0829320090120020092
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Korean Journal of Clinical Microbiology
2009 Volume.12 No. 2 p.92 ~ p.96
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A Case of Streptococcus salivarius Meningitis in a Patient with Cerebrospinal Fluid Rhinorrhea after Skull Base Fracture
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Shin Kyeong-Seob
Shin Dong-Ick
Shim Woo-Sub
Rim Byeong-Cheol
Bae Il-Hun
Lee Seung-Young
Ryu Dong-Hee
Kim Eun-Jung
Son Bo-Ra
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Abstract
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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=0.25μg/mL) but was susceptible to cefotaxime MIC=0.25μg/mL) and vancomycin (MIC=0.75μg/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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KEYWORD
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Streptococcus salivarius, Meningitis, Skull fracture, Basilar
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