van der Hoeven Adrienne Elisabeth, Kerremans Josephus Johannes, Lagrand Tjerk Joppe
Department of Neurology, Alrijne Ziekenhuis, Leiderdorp, The Netherlands.
Department of Medical Microbiology, Alrijne Ziekenhuis, Leiderdorp, The Netherlands.
Case Rep Neurol. 2024 Oct 4;16(1):269-273. doi: 10.1159/000541631. eCollection 2024 Jan-Dec.
is a Gram-negative bacterium found in the oral flora of dogs and cats, transmitted to humans through bites, licks, or scratches. Infections can lead to severe manifestations, including meningitis, particularly in immunocompromised individuals.
A 46-year-old immunocompetent man presented with somnolence, headache, and fever after being licked by his dog. Neurological examination revealed signs of meningeal irritation, and cerebrospinal fluid analysis showed an elevated white cell count and protein levels consistent with bacterial meningitis. Treatment followed Dutch guidelines with amoxicillin, ceftriaxone, and dexamethasone, resulting in rapid clinical improvement. Microbiological confirmation of . followed later. The patient was treated with antibiotics for the duration of 1 week and remained symptom-free after being discharged.
meningitis, although rare, poses diagnostic challenges due to its variable presentation and slow growth in culture. Empirical therapy guided by susceptibility testing contributes to favorable outcomes. This case underscores the importance of considering a . infection in patients with animal exposure and of taking diagnostic findings, precedent, and clinical response into account when determining the treatment duration.
是一种革兰氏阴性菌，存在于犬猫口腔菌群中，可通过咬伤、舔舐或抓挠传播给人类。感染可导致严重表现，包括脑膜炎，尤其是在免疫功能低下的个体中。
一名46岁免疫功能正常的男性在被其狗舔舐后出现嗜睡、头痛和发热症状。神经系统检查发现脑膜刺激征，脑脊液分析显示白细胞计数和蛋白质水平升高，符合细菌性脑膜炎表现。治疗遵循荷兰指南，使用阿莫西林、头孢曲松和地塞米松，临床症状迅速改善。随后进行了 的微生物学确诊。患者接受了为期1周的抗生素治疗，出院后无症状。
脑膜炎虽然罕见，但因其表现多样且在培养中生长缓慢，给诊断带来挑战。药敏试验指导下的经验性治疗有助于取得良好疗效。本病例强调了在有动物接触史的患者中考虑 感染的重要性，以及在确定治疗疗程时考虑诊断结果、先例和临床反应的重要性。
