Pneumococcal Meningitis Successfully Treated with Adjuvant Management of Intrathecal Vancomycin, Oral Rifampicin and Shunt Surgery

Abstract

Background Bacterial meningitis is a life threatening medical emergency. We report one case of our patient with fulminant meningitis caused by Streptococcus pneumoniae, who was successfully treated by intravenous (IV) and intrathecal antibiotics with shunt operation. Case Report A 35-year-old male was transferred to emergency center for loss of consciousness after 1 day of fever. Bacterial meningitis was diagnosed based on cerebrospinal fluid (CSF) finding. IV antibiotics with steroid therapy were initiated with subsequent intrathecal injection of vancomycin, oral administration of rifampicin and shunt operation. CSF culture confirmed pneumococcal meningitis, which was also isolated from the site of chronic otitis media at the left ear. After 4 weeks of antibiotics and surgical management of chronic otitis media, the patient fully recovered and was discharged without any neurological sequelae. Conclusion Aggressive management with antibiotics and surgical intracranial pressure control may be a treatment options for fulminant bacterial meningitis.

Keywords

• Bacterial meningitis
• Intrathecal vancomycin