Purulent meningitis caused by Actinomyces successfully treated with rifampicin: a case report |
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Authors: | Imamura Keiko Kamitani Hideki Nakayasu Hiroyuki Asai Yasumasa Nakashima Kenji |
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Affiliation: | Department of Neurology, Tottori Prefectural Central Hospital, Japan. imamurakeiko@nifty.com |
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Abstract: | A 64-year-old woman presented with fever and headache. Lumbar puncture revealed cerebrospinal fluid (CSF) that contained 67,386 /mm(3) of WBC; CSF culture revealed Actinomyces species. She was diagnosed with purulent meningitis caused by actinomyces, and treated with intravenous ampicillin 12 g/day. The administration of ampicillin was effective, but not sufficient to control the inflammation in CSF. CSF inflammation persisted and a gradual increase in granulation tissue was found in the subdural space on lumbar MRI. After administration of rifampicin 450 mg/day, the CSF was normalized and the enhancement of granulation tissue decreased. The patient completely recovered 5 months after the therapy was initiated. We suggest that rifampicin may be an option for the treatment of meningitis caused by actinomyces. |
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