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Abstract - Otogenic meningoencephalitis caused by Streptococcus pneumoniae
Tsetsa Georgieva Doichinova, Galya Ivanova Gancheva, Stefan Ivanov Mirchev, Nachko Iliev Totsev

Meningitis/ meningoencephalitis due to Streptococcus pneumoniae are with severe course and high mortality rate. A case of severe meningoencephalitis by S.pneumoniae secondary to chronic bilateral otitis and mastoiditis is presented here. A 37-year-old male patient was admitted with fever, excitation, somnolence and meningeal irritation. Investiga­tion of cerebrospinal fluid (CSF) revealed increased protein level (11.3 g/L), leucocytes count 59,790/μL (93% neutro­phils), extremely decreased glucose level (0.1 mmol/L). S.pneumoniae was confirmed by latex test and culture of CSF. Otitis media and mastoiditis were found bilaterally by computerized tomography. Bilateral cortical mastoidectomy was performed together with antibacterial treatment by consequently ceftazidime and cefepime and corticosteroids were administered. He experienced progressive improvement and was discharged with normal laboratory parameters and without sequels after 17 days hospital treatment. In conclusion, both surgical and conservative treatments are crucial for outcome of meningitis/ meningoencephalitis by S.pneumoniae secondary to chronic mastoiditis. J Microbiol Infect Dis 2013; 3(2): 86-88

Key words: Streptococcus pneumoniae, meningitis, meningoencephalitis, mastoiditis

Volume 03, Number 02 (2013)