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继发于导管相关血流感染的无神经外科装置的表皮葡萄球菌脑膜炎:一例病例报告及文献复习

Staphylococcus epidermidis meningitis in the absence of a neurosurgical device secondary to catheter-related bloodstream infection: a case report and review of the literature.

作者信息

Noguchi Taro, Nagao Miki, Yamamoto Masaki, Matsumura Yasufumi, Kitano Toshiyuki, Takaori-Kondo Akifumi, Ichiyama Satoshi

机构信息

Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.

Department of Hematology and Oncology, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.

出版信息

J Med Case Rep. 2018 Apr 25;12(1):106. doi: 10.1186/s13256-018-1646-7.

Abstract

BACKGROUND

Staphylococcus epidermidis can cause nosocomial meningitis in the presence of prosthetic devices. We describe a case of Staphylococcus epidermidis meningitis in a patient with neutropenia who had no intracranial foreign body, and we review the literature on meningitis that is caused by coagulase-negative Staphylococcus spp. without a neurosurgical device.

CASE PRESENTATION

A 47-year-old Japanese man with acute myeloid leukemia receiving chemotherapy through a totally implantable central venous catheter developed fever and headache. The patient had a history of craniotomy for anaplastic oligodendroglioma without an indwelling neurosurgical device. The results of two blood cultures and a cerebrospinal fluid culture were positive for Staphylococcus epidermidis. Clinical improvement was observed with treatment with vancomycin and removal of the central venous catheter despite prolonged neutropenia.

CONCLUSIONS

To the best of our knowledge, this is the first reported case of Staphylococcus epidermidis meningitis in a patient with neutropenia without a neurosurgical device who was successfully treated.

摘要

背景

表皮葡萄球菌在存在假体装置的情况下可引起医院获得性脑膜炎。我们描述了一例无颅内异物的中性粒细胞减少患者发生表皮葡萄球菌脑膜炎的病例,并回顾了关于由凝固酶阴性葡萄球菌属引起的无神经外科装置的脑膜炎的文献。

病例介绍

一名47岁的日本男性,患有急性髓细胞白血病,通过完全植入式中心静脉导管接受化疗,出现发热和头痛。该患者有因间变性少突胶质细胞瘤行开颅手术的病史,无留置神经外科装置。两次血培养和一次脑脊液培养结果均显示表皮葡萄球菌阳性。尽管中性粒细胞减少持续时间较长,但通过万古霉素治疗和拔除中心静脉导管,临床症状得到改善。

结论

据我们所知,这是首例报道的无神经外科装置的中性粒细胞减少患者发生表皮葡萄球菌脑膜炎且成功治疗的病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9951/5916725/a9b0a208d83d/13256_2018_1646_Fig1_HTML.jpg

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