Braın Abscess Due To Proteus Mirabilis Meningitis As A Complication Of Mastoiditis: Case Report

Abstract

Meningitis and intracranial abscess due to Proteus mirabilis is seen especially in the neonatalperiod and among the patients with immune deficiency. It was learned that 35 years old malepatient who applied to the emergency room with ongoing fever, nausea and vomiting for threedays have had their upper left jaw tooth out 10 days ago. As clinical and laboratory to patientswith acute bacterial meningitis empirical ceftriaxone 2x2 gr/day parenteral was started. Thecranial MR of the patient, that has P. mirabilis producing in their blood and cerebrospinal fluid(CSF) culture, was taken at the seventh day of hospitalization as his complaints started again.In the MR, abscess was detected in the left temporal brain of the patient and a surgical treatmentwas applied. Complete healing was seen eight week treatment with antibiotics after surgery.During application it was though that meningitis has occurred due to the dental surgery, howeverafter the temporal BT, mastoiditis was detected. It was thought that meningitis and brain abscessdeveloped on the patient was caused by mastoiditis. Even with sensitive antibiotics if norecovery is observed in patients with meningitis, intracranial abscess should be considered, alsoit should not be forgotten that in adults and patients with no immune deficiency meningitis dueto P. mirabilis may develop

Keywords

• Proteus mirabilis,meningitis,brain abscess

Mastoiditin Komplikasyonu Sonucu Gelişen Proteus Mirabilis Menenjitine Bağlı Beyin Absesi: Olgu Sunumu

Abstract

Proteus mirabilis’e bağlı menenjit ve intrakraniyal apse gelişimi, özellikle neonatal dönemdeve immün yetmezliği olan bireylerde görülmektedir. Acil servise; üç gündür devam eden ateş,bulantı ve kusma yakınmalarıyla başvuran 35 yaşında erkek hastanın, 10 gün önce sol üstçeneden diş çektirdiği öğrenildi. Klinik ve laboratuar olarak akut bakteriyel menenjit ile uyumluolan hastaya ampirik seftriakson 2x2 gr/gün parenteral başlandı. Kan ve beyin omurilik sıvısı(BOS)’nda P. mirabilis üreyen hastanın; yatışın yedinci gününde yakınmalarının tekrar başlamasıüzerine, kranial MR çekildi. MR’da sol temporalde beyin apsesi saptanan hastaya cerrahi tedaviuygulandı. Cerrahi sonrası sekiz haftalık antibiyotik tedavisi ile tamamen iyileşme görüldü.Başvuru sırasında menenjitin dental cerrahiye bağlı oluştuğu düşünülen hastada, daha sonraçekilen temporal BT sonrası mastoidit tespit edildi. Olguda gelişen menenjit ve beyin absesininmastoidite bağlı olduğu düşünüldü. Menenjit olgularında, duyarlı antibiyotiğe rağmen düzelmesaptanmaması durumunda intrakranial apse düşünülmeli, erişkin ve immün yetmezliği olmayanolgularda da P. mirabilis’e bağlı menenjit gelişebileceği unutulmamalıdır

Keywords

• Proteus mirabilis,menenjit,beyin apsesi

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