Penicillin-resistant pneumococcal meningitis following a head trauma in a chronic alcoholic patient

Year 2018, , 357 - 360, 28.12.2018

Kader Arslan Salih Cesur , Şükran Sevim Ayşe Büyükdemirci Çiğdem Ataman Hatipoğlu Sami Kınıklı

https://doi.org/10.18663/tjcl.462004

Abstract

Chronic alcohol use may
suppress central nervous system infections or interfere with clinical
conditions such as alcohol withdrawal syndrome. Sensitivity to infectious
agents is increased in alcoholic patients due to the impaired immunological
response to microorganisms, malnutrition and vitamin deficiency. The most
common meningitis in these patients is Streptococcus pneumoniae. Penicillin
resistance in pneumococci, is a major source of concern in recent years all
over the world and in Turkey. In the treatment of pneumococcal infections,
which are highly resistant to penicillin, a combination of third-generation
cephalosporins (ceftriaxone, cefotaxime) and vancomycin is applied along with
dexamethasone therapy. If there is a delay in the diagnosis and treatment of
pneumococcal meningitis, the mortality rate is high. In this article, we
present a 40-year-old male patient with chronic alcohol use history who was
diagnosed with penicillin-resistant Streptococcus
pneumoniae meningitis with delayed diagnosis and mortality which was
developed after a head trauma. 

Keywords

Alcoholic head trauma, meningitis, penicillin-resistant pneumococcus

Kronik alkol kullanımı olan bir hastada kafa travmasını takiben gelişen penisiline dirençli pnömokok menenjiti

Abstract

Kronik alkol kullanan
bireylerde santral sinir sistemi infeksiyonu bulguları baskılanabilir veya
alkol yoksunluk sendromu gibi klinik durumlarla karışabilir. Alkolik hastalarda
mikroorganizmalara karşı immun yanıtın etkilenmesi, malnutrisyon ve vitamin
eksikliği gibi nedenlerle infeksiyon etkenlerine karşı duyarlılık artar. Bu
hastalarda en sık görülen menenjit etkeni Streptococcus
pneumoniae’dır. Pnömokoklarda penisilin direnci son
yıllarda tüm dünyada ve Türkiye’de önemli bir endişe kaynağıdır. Penisiline
yüksek düzey dirençli pnömokok infeksiyonlarının tedavisinde üçüncü kuşak
sefalosporinler (seftriakson, sefotaksim) ve vankomisin kombinasyonu ile
birlikte deksametazon tedavisi tercih edilir. Pnömokokal menenjitte tanı ve tedavide gecikme olması durumunda mortalite
oranı yüksektir. Bu yazıda, kronik alkol kullanımı öyküsü olan 40 yaşında bir
erkek hastada kafa travmasını takiben gelişen, geç tanı konulan ve mortal
seyreden penisiline dirençli Streptococcus
pneumoniae menenjiti olgusu sunuldu.  

Keywords

Alkolik hasta, kafa travması, menenjit, penisiline dirençli pnömokok

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