We report a case of a 62-year-old man treated for Streptococcus pneumoniae meningitis by ceftriaxone and dexamethasone. After neurological improvement, neurological degradation by vasculitis occurred, despite effective concentrations of ceftriaxone in the serum and cerebrospinal fluid (CSF). S. pneumoniae with increased MICs to third-generation-cephalosporins (3GC) was isolated from the ventricular fluid 10 days after the isolation of the first strain. Isolate analysis showed that a mutation in the penicillin-binding protein 2X (PBP2X) has occurred under treatment.
All Keywords
【저자키워드】 Meningitis, Streptococcus pneumoniae, treatment failure, penicillin-binding protein, 3GC resistance, meningitis-related delayed cerebral injury,
【저자키워드】 Meningitis, Streptococcus pneumoniae, treatment failure, penicillin-binding protein, 3GC resistance, meningitis-related delayed cerebral injury,