Rinsho Shinkeigaku (Clinical Neurology)

Case Report

Bacterial meningitis with Campylobacter fetus manifesting chronic clinical course

Mitsuaki Shioyama, M.D., Ph.D.1), Yoshiyuki Mitui, M.D., Ph.D.1), Haruo Ueda, M.D.2), Kazuo Takada, M.D., Ph.D.1), Jyuri Kureshiro, M.D.1), Masataka Kitaguchi, M.D., Ph.D.2) and Susumu Kusunoki, M.D., Ph.D.1)

1)Department of Neurology, Kinki University School of Medicine
2)Department of Neurology, Baba Memorial Hospital

A 43-year-old man with no past history of underlying disease was admitted to an affiliated hospital, complaining of high fever and severe headache. Polynuclear dominant pleocytosis in the cerebrospinal fluid (CSF) suggested bacterial meningitis. He was immediately treated with several antibiotics, then his clinical symptoms improved, although intractable headache relapsed after withdrawal of the initial therapy. Thereafter he consulted our hospital for a second opinion. CSF examination in our hospital demonstrated mononuclear dominant pleocytosis with normal sugar value. However, bacterial culture of the CSF specimen yielded a gram-negative bacillus that was finally identified as a Campylobacter fetus on Skirrow's culture. Treatment with meropenem and other antibiotics improved both the clinical symptoms and CSF findings. Thus, meningitis with a Campylobacter fetus could manifest a chronic and atypical clinical course, careful attention should be paid to establish an early diagnosis.

(CLINICA NEUROL, 46: 699|701, 2006)
key words: Campylobacter fetus, chronic meningitis, mononuclear pleocytosis

(Received: 13-Apr-06)