A Case of Campylobacter fetus subspecies fetus Meningitis

• Published in: Kansenshogaku Zasshi Vol. 67; no. 1; pp. 66 - 70
• Main Authors: INOUE, Yuichi, OHTSUBO, Takakazu, MORI, Norihiko, ISHINO, Tohru, TAKASE, Tomiko, KAKU, Mitsuo, KOGA, Hironobu, KOHNO, Shigeru, HARA, Kohei
• Format: Journal Article
• Language: Japanese; English
• Published: Japan The Japanese Association for Infectious Diseases 1993
• Subjects: Adult; bacteremia; Campylobacter fetus; Campylobacter fetus - isolation & purification; Campylobacter Infections; Cilastatin - administration & dosage; Cilastatin, Imipenem Drug Combination; Drug Combinations; Drug Therapy, Combination; Fosfomycin - administration & dosage; Humans; Imipenem - administration & dosage; Male; meningitis; Meningitis, Bacterial - drug therapy; Meningitis, Bacterial - microbiology; Minocycline - administration & dosage
• ISSN: 0387-5911; 1884-569X
• DOI: 10.11150/kansenshogakuzasshi1970.67.66

A 40-year-old male with no history of underlying disease was admitted to Hokusho Central Hospital on May 25, 1991, complaining of high fever and headache. Physical examination on admission revealed a temperature of 38.5°C, a pulse rate of 84 beat/min (relative bradycardia) and no abnormal findings for the chest or abdomen. Slight neck stiffnes without Kernig's sign was observed at neurological examination. Laboratory data were: ESR 11mm/lh, WBC 12000/mm3, C-reactive protein positive. Lumbar puncture showed an initial pressure of 230 mmH2O; CSF revealed a cell count of 2633/3mm3 with mononuclear pleocytosis, total protein of 76mg/dl and sugar of 54mg/dl (CSF: blood glucose ratio 0.47). We initially suspected tuberculous or cryptococcal meningitis, but Campylobacter fetus subsp. fetus (C. fetus) was isolated from the CSF and venous blood on the 27th hospital day. IPM/CS 1g/day, MINO 200mg/day and FOM 4g/day were intravenously administered. This antibiotic therapy was very effective: the patient was soon afebrile, and gradually all signs and symptoms were resolved. C. fetus was sensitive to IMP/CS, MINO, KM, GM, EM, OFLX, CP. The patient was discharged with no complication. He has eaten raw beef frequently before admission, but stool culture for C. fetus was negative.