Meningitis due to enterotoxigenic Bacteroides fragilis.

An enterotoxigenic strain of Bacteroides fragilis was the sole organism isolated from the cerebrospinal fluid of a two-and-a-half-month neonate who had a medullary-colonic fistula as part of a complex congenital malformation, but no brain abscess. A rapid latex particle agglutination test for detection of bacterial antigen was positive for Haemophilus influenzae type b, suggesting that Bacteroides fragilis and Haemophilus influenzae type b might share some capsular antigens. In order to determine the role of the enterotoxin with respect to virulence of the strain, antibodies to a 20 kDa protein were sought in the patient's serum, but Western blot of the culture supernatant revealed only antibodies to a 45 kDa bacterial protein. The patient was successfully treated with metronidazole and imipenem.

[Bacteroides distasonis meningitis]. / Meningitis por Bacteroides distasonis.

A 50 year old woman while undergoing severe treatment for rheumatoid arthritis, developed anaerobic meningitis. The cerebrospinal fluid (CSF) sample was transported and cultivated aerobically and anaerobically. After 48 h at 37 degrees C the anaerobically incubated plate, the enriched fluid thioglycollate medium and the anaerobic culture medium yielded luxuriant growth of an anaerobic Gram negative bacillum. The biochemical and antimicrobial susceptibility patterns were consistent with those for Bacteroides distasonis. Most of the strains of the 5 species included in the Bacteroides fragilis group (B. fragilis, B. vulgatus, B. ovatus, B. thetaiotaomicron and B. distasonis) are resistant to penicillins, cephalosporins of first generation and aminoglycosides. Anaerobic polyresistant flora from an intraabdominal focus (chronic cholecystitis) might have been selected by treatment with gentamicin and cephalotin, and proliferated into meningeal dissemination. It is important that CSF from immunocompromised patients with acute or chronic pulmonary, intraabdominal or cranium-facial infectious processes be transported and cultured in aerobic and anaerobic conditions. These patients must be treated with an initial therapeutic scheme that includes an effective antibiotic for the anaerobic microorganism that may be involved.

Central nervous system infection associated with anaerobic bacteria in two dogs and two cats.

Central nervous system (CNS) infection caused by anaerobic bacteria (including Bacteroides, Fusobacterium, Peptostreptococcus, and Eubacterium) was diagnosed in two dogs and two cats. In one dog there was extensive meningomyeloencephalitis, presumably the result of hematogenous spread of bacteria from lung abscesses and bacterial endocarditis. Subdural empyema of unknown origin was found in a second dog and two cats. Clinical signs in all four animals included mental depression and focal neurologic deficits, without fever.

Bacteroides fragilis meningitis successfully treated with metronidazole after a previous failure with thiamphenicol.

A case of pyogenic meningitis caused by Bacteroides fragilis in a 72-year-old woman is reported. Although the isolate was susceptible to thiamphenicol, the patient did not respond to this drug. Metronidazole, which showed high bactericidal activity, was administered and achieved sterilization of the cerebrospinal fluid and complete clinical response.

[The role of anaerobic bacteria in meningeal infections (author's transl)]. / Il ruolo dei batteri anaerobi nelle infezioni meningee.

The finding is described of a Gram-negative bacterium in cerebrospinal fluid of a patient suffering from internal hydrocephalus and taken in the hospital of Udine with symptoms of meningitis. The isolated bacterium belongs to the genus Bacteroides. The cases of meningitis are indicated in which the bacteriological examination of the cerebrospinal fluid for anaerobes is recommended.