Rinsho Shinkeigaku (Clinical Neurology)

Brief Clinical Note

A case of meningococcal meningitis that was difficult to treat owing to concurrent ventriculitis

Hiroaki Nakahara, M.D., Ph.D.1), Toshimi Oda, M.D.2), Eri Fukao, M.D.1), Izumi Horiuchi, M.D., Ph.D.1)3), Yutaka Honma, M.D.1) and Masanobu Uchigata, M.D.1)4)

1)Department of Neurology, Showa General Hospital
2)Department of Infectious Diseases, Showa General Hospital
3)Izumi Clinic
4)Department of Rehabilitation, Kamata Rehabilitation Hospital

A 64-year-old male came to our hospital emergency department with fever and consciousness disturbance. Culture tests of blood and spinal fluid samples revealed meningococci (Neisseria meningitidis), and we made a diagnosis of meningococcal meningitis. Brain magnetic resonance imaging (MRI) findings revealed ventriculitis. Ceftriaxone was administered for 17 days, however, relapse was noted after that was discontinued, with neutropenia and renal impairment thought to be adverse reactions to the beta-lactam antibiotic. Hence, treatment was switched to oral administration of moxifloxacin for a total of 12 weeks, including in an outpatient setting. After moxifloxacin was discontinued, no side effects or relapse were seen, and treatment was ended. Although antibacterial agents generally show favorable effects for meningococcal meningitis, we consider that sufficient antimicrobial therapy is difficult in cases complicated with ventriculitis.
Full Text of this Article in Japanese PDF (450K)

(CLINICA NEUROL, 56: 344|347, 2016)
key words: meningococcal meningitis, ventriculitis, moxifloxacin

(Received: 10-Oct-15)