Fig.1 Case 1,E.H.Clinical Course of Campylobacter Meningitis Table 1 Case 1.E.H.

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Transcription:

Key words: Campylobacter fetus,meningitis

Fig.1 Case 1,E.H.Clinical Course of Campylobacter Meningitis Table 1 Case 1.E.H.

273 昭 和61年3月20日 Table 2 Case 2.T.N. Fig.3 Case2,T.N.Clinical Campylobacter Fig.2 C.fetus in gram Course of Meningitis stain Fig.4 Case 2.T.N.Serum and Liquor Concentration of Rokitamycin(300mg P.O.) (300mg P.O.) bacter fetus subsp.fetucsと 療 をRokitamycinに 同 定 した.こ のた め 治 変 更 し発 熱,頭 痛 は や や 減 少 す る も 効 果 不 十 分 で あ っ た.な おRokitamycinの 血 中 濃 度 は300mg経 に0.625μg/mlで 口1回 あ っ た が,髄 以 下 で あ っ た(Fig.4).患 MINO,EM,TC,ア た.ABPC 投 与 に て2時 間 後 液濃 度 は測 定 限界 者 分 離 菌 は,ABpc, ミ ノ配 糖 体 に 感 受 性 を 示 し 12g/日 の 点 滴 とTOB 髄 注 に 治 療 を 変 更 し,4週 所 見 と も に 改 善 し1984年1月 5mg/日 週2回 間 に て 臨 床 症 状,髄 退 院 し た.発 液 症 前に 食 べ た 牛 の 生 肝 が 感 染 経 路 と考 え ら れ た が 患 者 の 血 液 培 養,便 培 養 か らCfetztsは 検 出されなか っ

Fig.5)Differentitation of Campylobacter species(modified from ref.1) Nalidixic acids TTC;growth in lmg/ml triphenyltetrazolium Sn;Sn deoxydate W;weakly positive BG3;growth in brilliant green 1/33,000 Glu;growth Nd;growth in 8%glocose in 40 pg/ml chioride

3) Schmit, U., et al.: The clinical spectrum of Campylobacter fetus infection: Report of five cases and review of the literature. Q. J. Med., 196: 431-442, 1980. 18) Guerrant, R. T., et al.: Pathogenic mecanisms and review of 91 blood-stream infections.am. J. Med., 65: 584-592, 1978. 19) Rettig, P.J.: Campylobacter infections in human beings. J. Pediatrics, 94: 855-864, 1979.

Two Cases of Campylobacter fetus Meningitis Yube IIDA,Kunihiko SUNAGA,Keigo MAEHARA,Yuruko OKAMOTO & Kojiro YASUNAGA Internal Medicine Kansai Medical University Keiko NISHIURA Second Medicine Kansai Medical University Kenji SHIMOSHIKIRYO Department of Clinical Laboratory Two cases of Campylobacter fetus Meningitis without underlying diseases were reported. Case 1.A- 42-year-old man had high fever and headache in December,1977.He was treated by personal physician, but he complained nausea, vomiting and tinnis.he was admitted to the Kansai Medical University on January 17,1978.The CSF findings showed that initial pressure was 190mm H2O,cell count was 960/3mm3(all lymphocyte),protein level was 130mg/dl,glucose level was 37mg/dl,and tryptophan test was positive.he was treated with Isoniazide,Streptomycin and Rifampicin for suspected tuberclous meningitis.but Campylobacter fetus subsp.fetus(c.fetus)was isolated from CSF.It was sensitive to AB PC,MINO,TC,CP,and aminoglycosides.we used MINO 200 mg/day for 6 weeks.the patient was discharged as recovered in March,1978.Stool and blood culture were negative for C.fetus.The patient did not have a history contact with animals.the infection route was not detected.case 2.A-30-year-old man admitted on November,15,1983 because high fever and headache.two weeks earlier he ate raw beef liver with his friend.his conciousness was clear but neck stiffness was present.the CSF findings showed that turbirity was positive,initial pressure was 170mm H2O,cell count was 129mg/dl,and glucose level was 65mg/dl.We found gram-negative spinal rods in gram stain,and C.fetus was isolated from CSF.Rokitamycin 1200 mg/day was orally administered,but fever and headahe continued.csf and serum levels of Rokitamycin(300 mg orally administered)were measured.serum peak level was 0.625,ug/ml at 2 hours,but CSF levels were lower than measurable level.it was sensitive to AB PC, MINO,EM,TC,and aminoglycosides.we used AB PC 12g/day intravenously and TOB 5mg/day intrathecally twice a week for 4 weeks.he was discharged as recovered on January,1984.He ate raw beef liver,but his blood and stool culture for C.fetus were negative. And stool culture for C.fetus of his friend was negative.

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