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Propionibacterium acnes Meningitis in a Previously Normal Adult
Maj Jacob J. Schlesinger, MC;
Capt Allan L. Ross, MC
Arch Intern Med. 1977;137(7):921-923.
Abstract
A 25-year-old man was previously healthy until he contracted acute Propionibacterium acnes meningitis. Comparison with previous reports of de novo diphtheroid meningitis suggests that this entity can appear with features that are not characteristic of acute bacterial meningitis, including (1) stroke-like syndromes, (2) an afebrile course, and (3) a cerebrospinal fluid with a mononuclear pleocytosis and normal glucose level. The appropriate choice and dosage of antimicrobial agent must be guided by more than in vitro sensitivity data to prevent relapse and possible chronic meningitis. Although diphtheroids are as a rule exquisitely sensitive to penicillin, predictably high tissue levels of drug in diphtheroid meningitis are best achieved with chloramphenicol treatment. In the appropriate setting, the isolation of diphtheroids from cerebrospinal fluid should not be discounted as a "contaminant."
(Arch Intern Med 137:921-923, 1977)
Author Affiliations
USAR; USA
From the Department of Medicine, Madigan Army Medical Center, Tacoma, Wash.
Footnotes
Accepted for publication Aug 2, 1976.
Reprint requests to Department of Medicine, Rochester General Hospital, University of Rochester School of Medicine and Dentistry, 1425 Portland Ave, Rochester, NY 14621 (Dr Schlesinger).
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