A case of overwhelming postsplenectomy infection by fluoroquinolone-resistant noncapsulated <i>Neisseria meningitidis</i>

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  • フルオロキノロン耐性，莢膜多糖体非合成髄膜炎菌による脾臓摘出後重症感染症の一例
  • フルオロキノロン タイセイ,キョウマク タトウタイ ヒゴウセイ ズイマクエンキン ニ ヨル ヒゾウ テキシュツ ゴ ジュウショウ カンセンショウ ノ イチレイ

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Abstract

<p>We experienced treating a case of overwhelming postsplenectomy infection (OPSI) by noncapsulated Neisseria meningitidis . A female patient in her 60s visited the outpatient department of a local hospital owing to fever and vomiting. Since she could not articulate clearly and acute cerebral infarction was suspected following brain MRI examination, she was urgently transported and admitted to our hospital. Because of the increase in the levels of serum inflammatory markers, meropenem (MEPM) and vancomycin (VCM) were administered at doses appropriate for the initial treatment of suspected systemic infection. Gram-negative cocci were then detected from blood culture tests, and it was revealed that the patient had had a splenectomy; thus, the antibiotic drug was changed to ceftriaxone (CTRX). The gram-negative cocci were identified as fluoroquinolone-resistant N. meningitidis by mass spectrometry and drug sensitivity tests. Since no increase in the number of cells in her cerebrospinal fluid was observed after CTRX administration and the culture became negative, she was discharged on the 17th day. The serotypes and genotypes of N. meningitidis in this case were later identified as a noncapsulated strain.</p>

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