ESCHERICHIA COLI MENINGITIS IN AN ADULT
Keywords:
Meningitis, Eshcerichia coli; Immunocompromised; Imipenem; Cerebrospinal fluid; ParaplegiaAbstract
Introduction: Escherichia meningitis in adults is unusual. We report Escherichia coli meningitis in a 65 years old paraplegic Afghan male who had a history of accidental spinal injury. The interval between accidental trauma and the onset of meningitis was thirty days.
Materials & Methods: The case is of an immunodeficient 65 years old male Afghan, paraplegic due to accidental spinal injury thirty days earlier, but now hospitalized with meningitis like symptoms of high grade fever, headache and irritability. Cerebrospinal fluid, blood and urine samples were sent to the laboratory for specific etiology. The patient was kept on empirical treatment of Vancomycin and Ceftriaxone. Upon isolation of Extended Spectrum B-Lactamase (ESBL) producing Escherichia coli strain, the treatment was changed to Imipenem according to the culture sensitivity report.
Results: Despite treatment, the patient died due to septic shock after 3 days.
Conclusion: Imipenem should be the first choice in treatment of bacterial meningitis. Even with proper diagnosis and management, meningitis has a poor prognosis.
