[Implication of dexamethasone adjunctive therapy after the onset of cerebral vasculitis in Streptococcus pneumoniae meningitis]. / Implication du traitement adjuvant par dexaméthasone dans la survenue d'une artérite septique cérébrale au cours d'une méningite à Streptococcus pneumoniae.
Med Mal Infect
; 37(2): 118-20, 2007 Feb.
Article
em Fr
| MEDLINE
| ID: mdl-17267155
ABSTRACT
Few adverse effects have been reported with adjunctive dexamethasone treatment in pneumococcal meningitis. Nevertheless, we report a case of cerebral vasculitis. A 49-year-old man was admitted for fever and altered mental status. Lumbar puncture revealed a high inflammatory response and Streptococcus pneumoniae was identified by culture. Antibacterial therapy and adjunctive dexamethasone treatment were initiated as recommended. The immediate outcome was favorable but due to the onset of focal cerebral abnormalities, a CT scan was performed on the ninth day showing cerebral vasculitis. The patient died on the thirteenth day despite antibacterial therapy and resuscitation. In our case, a secondary neurological worsening appeared when adjunctive dexamethasone treatment was stopped suggesting a rebound effect. Observation of similar cases may lead to modifying adjunctive dexamethasone treatment protocol in bacterial meningitis.
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Coleções:
01-internacional
Contexto em Saúde:
2_ODS3
/
3_ND
Base de dados:
MEDLINE
Assunto principal:
Síndrome de Abstinência a Substâncias
/
Dexametasona
/
Vasculite do Sistema Nervoso Central
/
Meningite Pneumocócica
/
Anti-Inflamatórios
Tipo de estudo:
Etiology_studies
/
Guideline
/
Prognostic_studies
Limite:
Humans
/
Male
/
Middle aged
Idioma:
Fr
Revista:
Med Mal Infect
Ano de publicação:
2007
Tipo de documento:
Article