Schlesinger J J, Ross A L
Arch Intern Med. 1977 Jul;137(7):921-3.
A 25-year-old man was previously healthy until he contracted acute Propionibacterium acnes meningitis. Comparison with previous reports of de novo diphtheroid meningitis suggests that this entity can appear with features that are not characteristic of acute bacterial meningitis, including (1) stroke-like syndromes, (2) an afebrile course, and (3) a cerebrospinal fluid with a mononuclear pleocytosis and normal glucose level. The appropriate choice and dosage of antimicrobial agent must be guided by more than in vitro sensitivity data to prevent relapse and possible chronic meningitis. Although diphtheroids are as a rule exquisitely sensitive to penicillin, predictably high tissue levels of drug in diphtheroid meningitis are best achieved with chloramphenicol treatment. In the appropriate settling, the isolation of diphtheroids from cerebrospinal fluid should not be discounted as a "contaminant."
一名25岁男性此前身体健康，直至感染急性痤疮丙酸杆菌脑膜炎。与既往新发类白喉杆菌脑膜炎的报告相比，提示该疾病可能呈现出不具有急性细菌性脑膜炎特征的表现，包括：（1）类卒中综合征；（2）无发热病程；（3）脑脊液单核细胞增多且葡萄糖水平正常。抗菌药物的恰当选择和剂量必须依据体外药敏数据以外的因素来指导，以防止复发和可能出现的慢性脑膜炎。尽管类白喉杆菌通常对青霉素极为敏感，但在类白喉杆菌脑膜炎中，使用氯霉素治疗可更可靠地在组织中达到较高的药物水平。在适当的情况下，从脑脊液中分离出类白喉杆菌不应被视为“污染物”而不予考虑。
