Background
Case presentation
Lumbar puncture | 1st day | 6th day | 14th day | 22nd day | 31st day |
---|---|---|---|---|---|
Pressure mmH2O (80–180) | 300 | 300 | 160 | 110 | 110 |
Appearance (Colorless and transparent) | Colorless and transparent | Light yellow and transparent | Colorless and transparent | Colorless and transparent | Colorless and transparent |
Pandy’s test (−) | + | + | Weak positive | Weak positive | – |
WBC count 106/L (0–8) | 1536 | 204 | 107 | 36 | 11 |
Monocyte count 106/L (not available) | 602 | 164 | 106 | 36 | 10 |
Monocyte percentage % (not available) | 39.2 | 92.1 | 99.1 | 100.0 | 97.9 |
Multinucleate cell count 106/L (not available) | 934 | 40 | 1 | 0 | 1 |
Multinucleate cell percentage % (not available) | 60.8 | 7.9 | 0.9 | 0 | 2.1 |
RBC count 106/L (0) | 0 | 0 | 0 | 0 | 0 |
Glucose mmol/L (2.5–4.5) | 3.21 (RBG 6.80) | 2.32 (BG not tested) | 3.33 (FBG 5.71) | 3.03 (BG not tested) | 3.1 (FBG 4.54) |
Chlorine mmol/L (120–132) | 121.5 | 115 | 120.0 | 118.2 | 119.7 |
Protein g/L (0.15–0.45) | 1.08 | 0.84 | 0.52 | 0.41 | 0.33 |
Cryptococcus smear (Ink stain) | – | – | – | – | – |
Mycobacterium tuberculosis smear (Acid-fast stain) | – | – | – | – | – |
Bacterial smear (Gram’s stain) | – | – | – | – | – |
Bacterial culture (Plate cultivation) | – |
Enterococcus gallinarum
| – | – | – |
Antibiotic name | Method | Result | Sensitivity | Determination standard | ||
---|---|---|---|---|---|---|
Sensitive | Intermediary | Resistance | ||||
Penicillin G | MIC | 8.0 | S | ≥16 | ≤8 | |
Vancomycin | MIC | 2.0 | R | ≥32 | 8–16 | ≤4 |
Linezolid | MIC | 1.0 | S | ≥8 | 4 | ≤2 |
Tetracycline | MIC | ≥16.0 | R | ≥16 | 8 | ≤4 |
Ciprofloxacin | MIC | ≤0.5 | S | ≥4 | 2 | ≤1 |
Erythromycin | MIC | 8.0 | R | ≥8 | 1–4 | ≤0.5 |
Levofloxacin | MIC | 1.0 | S | ≥8 | 4 | ≤2 |
Ampicllin | MIC | ≤2.0 | S | ≥16 | ≤8 | |
Quinupristin/Dalfopristin | MIC | 1.0 | R | ≥4 | 2 | ≤1 |
Clindamycin | MIC | ≥8.0 | R | ≥4 | 1–2 | ≤0.5 |
Moxifloxacin | MIC | ≤0.25 | S | ≥4 | 2 | ≤1 |
Tigecycline | MIC | ≤0.12 | S | ≤0.25 | ||
Gentamicin-High | MIC | S | ||||
Streptomycin-High | MIC | R |
Discussion and conclusions
Reference | Country | Gender | Age | Symptoms | Susceptibility factors | Treatment | Outcome |
---|---|---|---|---|---|---|---|
Yoko Takayama, et al. [8] 2003 | Japan | Male | 57 years | Fever Neck stiffness | VP shunt for subarachnoid hemorrhage Rheumatoid arthritis with prednisolone and anti-rheumatic drugs | i.v. teicoplanin for 4 weeks VP shunt removal | Cured |
Yoko Takayama. et al. [8] 2003 | Japan | Male | 12 years | Fever Drowsy Limb cramps | VP shunt for astrocytoma | i.v. ampicillin for 8 weeks VP shunt replaced | Cured |
Asok Kurup, et al. [9] 2001 | Singapore | Male | 64 years | Fever Drowsy | VP shunt for multi-loculated hydrocephalus | i.v. ampicillin and gentamicin for 3 weeks | Cured |
Fahmi Yousef Khan, et al. [10] 2011 | Pakistan | Female | 53 years | Fever Headache Consciousness disturbance Neck stiffness | Decompression craniotomy for cerebral hemorrhage | i.v. linezolid for 3 weeks | Cured |
Vicente Sperb Antonello, et al. [11] 2010 | Brazil | Male | 53 years | Mental confusion Fever Ataxia Neck stiffness | Alcohol abuse | i.v. ampicillin and gentamycin for 3 weeks | Cured |
B. Roca, et al. [12] 2006 | Spain | Female | 51 years | Fever Headache | Cerebrospinal fluid drainage catheter for persistent right nostril rhinorrhea | i.v. ampicillin and rifampin for 3 weeks Drain removal | Cured |
Po-Yi Paul Su, et al. [5] 2016 | USA | Male | 53 years | Fever Neck stiffness | Acute lymphoblastic B cell leukemia with chemotherapy Neutropenic Broad-spectrum antibiotics usage Type 2 diabetes mellitus | i.v. ampicillin and ceftriaxone for 4 weeks | Cured |
Quanxiao Li, et al. [13] 2013 | China | Male | 2 days | Fever Hypermyotonia | Neonatal hemolysis | i.v. linezolid for 3 weeks | Cured |