Meningitis due to penicillin resistant Streptococcus pneumoniae occurring in a patient on long term ampicillin prophylaxis

Chadwick, Paul; Keaney, M.G.L.; Jones, R.A.C.

doi:10.1016/0163-4453(93)92126-h

Cited by 5 publications

(6 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…6,16 Meningitis with a penicillin-resistant strain of S pneumoniae has been reported in a patient with persistent dural fistula, CSF rhinorrhea, and a history of recurrent bacterial meningitis that had developed while the patient was taking prophylactic ampicillin. 17 A "23-valent polysaccharide Pnc vaccine" and a relatively new "7-valent conjugate Pnc vaccine" (licensed since 2001 in Europe) are recommended for persistent CSF leaks in some European countries. 18 The overall efficacy of pneumococcal vaccine was estimated at 64% in the United States in groups of patients at high risk for pneumococcal disease, and the efficacy did not differ significantly with age.…”

Section: Discussionmentioning

confidence: 99%

Risk of Meningitis with Cerebrospinal Fluid Rhinorrhea

Daudia

Biswas²,

Jones³

2007

Ann Otol Rhinol Laryngol

135

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Risk of Meningitis with Cerebrospinal Fluid Rhinorrhea

Daudia

Biswas²,

Jones³

2007

Ann Otol Rhinol Laryngol

135

View full text Add to dashboard Cite

show abstract

“…However, when the third episode occurred, the patient had been subjected to 23-valent capsular vaccination and was receiving chemoprophylaxis, as well as a biologically efficient antiretroviral treatment. Although the patient's compliance to the treatment could not be thoroughly assessed, this case highlights the uncertain efficacy of chemoprophylaxis [15], and differs from other previously reported cases in immunocompetent patients, where capsular vaccination and ampicillin prophylaxis were shown to reduce the recurrence rate of pneumococcal meningitis [16]. …”

Section: Discussionmentioning

confidence: 79%

Recurrent pneumococcal meningitis in a splenectomised HIV-infected patient

Morand

Veuillez

Poyart

et al. 2003

Ann Clin Microbiol Antimicrob

View full text Add to dashboard Cite

BackgroundStreptococcus pneumoniae is a major cause of human disease, especially in pre-school children and elderly people, as well as in special risk groups such as asplenic, antibody deficient patients, or presenting disruption of natural barriers. The occurrence of pneumococcal disease has increased with the onset of the HIV epidemic and the emergence of drug-resistance.Case presentationWe report the case of an HIV-1-infected patient who experienced three episodes of recurrent pneumococcal meningitis over a 4-year period, despite chemoprophylaxis and capsular vaccination.ConclusionsEfficacy of anti-pneumococcal chemoprophylaxis and vaccination in HIV-infected patients are discussed in the light of this particular case.

show abstract

“…Our knowledge regarding the exact risk of meningitis and the value of prophylactic antibiotics and/or pneumococcal vaccination in patients presenting with sCSF leaks is limited, and largely extrapolated from literature on patients with anterior skull base CSF leaks. The potential benefit of prophylactic antibiotics in reducing the risk of meningitis must be balanced against the risk of developing resistant pathogenic organisms 24 ; the ramifications of such should not be understated. [59][60][61] Given that surgical repair is the generally-accepted management for patients with sCSF leaks in order to reduce meningitis risk, no large series of patients who have been managed non-operatively exist from which it would be possible to assess the risk of meningitis in unrepaired leaks.…”

Section: Discussionmentioning

confidence: 99%

“…It is generally agreed upon that operative closure/ repair of the dural defect and CSF leak reduces the risk of meningitis. 18 Current practice regarding antibiotic prophylaxis prior to operative repair of sCSF leaks extrapolates upon data from anterior skull base leaks, which largely suggest lack of benefit [19][20][21][22][23][24] ; though considerable practice variation likely exists. 18,25 With streptococcus pneumoniae being the most common causative organism of meningitis complicating skull base CSF leaks, routine pneumococcal vaccination has been recommended by the CDC as an additional prophylactic measure in individuals with CSF leak.…”

Section: Introductionmentioning

confidence: 99%

Meningitis Risk and Role of Prophylactic Antibiotics in Spontaneous Lateral Skull Base CSF Leaks

Quimby

Ravin

Eliades

et al. 2023

Ann Otol Rhinol Laryngol

View full text Add to dashboard Cite

Objective: To review the literature and our institutional experience regarding the risk of meningitis in patients with spontaneous lateral skull base cerebrospinal fluid (sCSF) leaks awaiting surgical repair, and the roles of antibiotic prophylaxis and pneumococcal vaccination, if known. Methods: A retrospective chart review and systematic review of the literature was undertaken to identify the incidence of meningitis in patients with sCSF leaks awaiting surgical repair. Adults managed surgically for sCSF leaks at an academic tertiary care center over a 10-year period were included. Data was collected on receipt of prophylactic antibiotics and/or pneumococcal vaccines during the timeframe between diagnosis and surgical repair. Results: Institutional review identified 87 patients who underwent surgical repair of spontaneous leaks, with a 0% incidence of meningitis over a median duration of 2 months while awaiting surgery (mean 5.5 months, range 0.5-118 months). Eighty-eight percent of patients did not receive prophylactic antibiotics. No studies in the published literature demonstrated the impact of prophylactic antibiotics or pneumococcal vaccine on meningitis risk. Conclusions: There appears to be a low risk of meningitis among patients with lateral skull base sCSF leaks awaiting surgery for short durations (≤2 months), even in the absence of prophylactic antibiotics. There is a substantial gap in the published literature assessing the risk of meningitis and roles of antibiotics and vaccination in this patient population, indicating the need for large-scale study to conclusively elucidate the nature of this risk.

show abstract

Meningitis due to penicillin resistant Streptococcus pneumoniae occurring in a patient on long term ampicillin prophylaxis

Cited by 5 publications

References 4 publications

Risk of Meningitis with Cerebrospinal Fluid Rhinorrhea

Risk of Meningitis with Cerebrospinal Fluid Rhinorrhea

Recurrent pneumococcal meningitis in a splenectomised HIV-infected patient

Meningitis Risk and Role of Prophylactic Antibiotics in Spontaneous Lateral Skull Base CSF Leaks

Contact Info

Product

Resources

About