Abstract
BackgroundStaphylococcus epidermidis can cause nosocomial meningitis in the presence of prosthetic devices. We describe a case of Staphylococcus epidermidis meningitis in a patient with neutropenia who had no intracranial foreign body, and we review the literature on meningitis that is caused by coagulase-negative Staphylococcus spp. without a neurosurgical device.Case presentationA 47-year-old Japanese man with acute myeloid leukemia receiving chemotherapy through a totally implantable central venous catheter developed fever and headache. The patient had a history of craniotomy for anaplastic oligodendroglioma without an indwelling neurosurgical device. The results of two blood cultures and a cerebrospinal fluid culture were positive for Staphylococcus epidermidis. Clinical improvement was observed with treatment with vancomycin and removal of the central venous catheter despite prolonged neutropenia.ConclusionsTo the best of our knowledge, this is the first reported case of Staphylococcus epidermidis meningitis in a patient with neutropenia without a neurosurgical device who was successfully treated.
Highlights
ConclusionsTo the best of our knowledge, this is the first reported case of Staphylococcus epidermidis meningitis in a patient with neutropenia without a neurosurgical device who was successfully treated
Staphylococcus epidermidis can cause nosocomial meningitis in the presence of prosthetic devices
We report a case of a patient who developed S. epidermidis meningitis unrelated to the neurosurgical device and who was successfully treated in spite of profound and prolonged neutropenia
Summary
A literature review revealed that CoNS meningitis without a neurosurgical device has rarely been reported. No symptom or sign is reliably present in patients with neutropenia, and a high index of clinical suspicion is essential for prompt diagnosis. Because CoNS meningitis could be life-threatening, especially in patients with neutropenia, adequate antibiotic therapy with source control is critical for a successful outcome
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