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Revista Costarricense de Ciencias Médicas

Print version ISSN 0253-2948


MIRANDA, Erick; MADRIGAL, Fabián; MORA, Juan R  and  CAMACHO, Zianne. Meningitis y choque séptico en un adulto mayor causados por Chryseobacterium meningosepticum (antes Flavobacterium meningosepticum).. Rev. costarric. cienc. méd [online]. 2005, vol.26, n.3-4, pp.33-38. ISSN 0253-2948.

Chrysobacterium meningosepticum is an environmental bacterium that can survive in different nosocomial environments and is able to produce infections in debilitated patients by initial colonization of the respiratory tract. This bacterium exhibits resistance to many antimicrobial agents what makes very difficult its eradication from an infectious process. Clinical evolution of an infectious disease caused by C. meningosepticum in a 66 years old immunocompromised patient is described. Five days before being hospitalized, the patient exhibited progressive dyspnea and malaise. When the patient was admitted into the hospital she was afebrile and hypotensive; blood tests showed leukocytosis with juvenile forms (left shift) and kidney and liver functions altered. Supplementary oxygen and treatment for cardiac insuffi ciency were provided during the second day. At the third day she exhibited fever, dyspnea and tachycardia. Empirical antimicrobial treatment with cefotaxime and amikacin was started. Bacteriological cultures of urine and sputum taken at the time the patient was admitted to the hospital were negative. During fourth day the patient continued with fever, the respiratory problem got worse and delirium was present. Antimicrobial treatment was changed to cefotaxime, ampicillin and vancomycin and a lumbar puncture was performed. The cerebrospinal fl uid (CSF) showed 31000 leukocytes/ì L (92% polymorphonuclear leukocytes), elevated protein concentration and a high amount of Gram-negative bacilli in the sediment. A Gram-negative bacillus was also isolated from a blood culture previously taken. The fifth day of hospitalization, the patient entered in septic shock, the general condition got worse and she died. CSF and blood cultures were positive for C. meningosepticum. This case fits descriptions found in literature about C. meningosepticum, an uncommon microorganism causing meningitis and bacteremia in an immunocompromised patient (because of age, general condition and treatment with prednisone), that evolved to septic shock and dead in spite of regular antimicrobial treatment and medical care.

Keywords : Meningitis; Septic shock; Flavobacterium meningosepticum.

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