Meningitis due to Weissella Confusa
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W.B. Saunders
Abstract
Bacterial meningitis is a life-threatening condition that should be addressed as an emergency. The typical culprit microorganisms are targeted empirically with ceftriaxone and vancomycin, in the absence of an immunocompromised state. In this case report, however, we are describing a case of meningitis secondary to Weissella confusa, bacteria inherently resistant to the two drugs commonly used to empirically treat meningitis. Weissella spp. are Gram-positive, catalase-negative coccobacilli and an infrequent cause of infection in humans. Bacteremia followed by endocarditis are the typical clinical manifestations of W. confusa in humans. Other reported manifestations include post-operative osteomyelitis, thumb abscess, infected prosthetic joint, infected peritoneal fluid and peritonitis. To our knowledge, this is the first case of meningitis due to Weissella confusa in the literature. Therefore, we conclude that the isolation of Gram-positive coccobacilli resistant to vancomycin, especially in an immunocompromised host, should raise the suspicion of W. confusa. © 2020 Elsevier Inc.
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Atypical infections, Bacterial meningitis, Emergency departments, Weissella, Aged, Anti-bacterial agents, Fever, Humans, Immunocompromised host, Male, Meningitis, bacterial, Microbial sensitivity tests, Spinal puncture, Aciclovir, Ampicillin, Antivirus agent, Ceftriaxone, Clopidogrel, Dexamethasone, Ertapenem, Flumivir, Infusion fluid, Meropenem, Penicillin derivative, Unclassified drug, Vancomycin, Antiinfective agent, Alzheimer disease, Article, Bacterium identification, Bedridden patient, Bile duct stone, Case report, Cerebrospinal fluid analysis, Cerebrovascular accident, Cholangitis, Cholecystectomy, Clinical article, Clinical examination, Computer assisted tomography, Coronary artery disease, Disease duration, Drug megadose, Drug withdrawal, Ecchymosis, Eosinophil count, Erythrocyte count, Escherichia coli infection, Extended spectrum beta lactamase producing escherichia coli, Fecaloma, Human, Image analysis, Influenza, Lethargy, Leukocyte count, Listeriosis, Lymphocyte count, Matrix assisted laser desorption ionization time of flight mass spectrometry, Medical history, Minimum inhibitory concentration, Monocyte count, Neutrophil count, Non insulin dependent diabetes mellitus, Nonhuman, Pneumococcal meningitis, Priority journal, Rehydration, Skin examination, Staphylococcus hominis, Staphylococcus infection, Stiff neck, Stimulus response, Transluminal coronary angioplasty, Treatment duration, Treatment outcome, Treatment withdrawal, Urosepsis, Weissella confusa, Drug effect, Immunocompromised patient, Isolation and purification, Lumbar puncture, Microbial sensitivity test, Microbiology, Pathogenicity, Physiology, Procedures