Document Detail


Tularemic meningitis in the United States.
MedLine Citation:
PMID:  19364939     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Tularemia is a zoonotic disease caused by Francisella tularensis. Tularemia presents with various clinical illnesses, but meningitis is rare. OBJECTIVES: To describe a patient who developed typhoidal tularemia with atypical acute meningitis and to review the pathogenesis, clinical and laboratory features, and antibiotic drug treatment of reported cases of tularemic meningitis. DESIGN: Case study and literature review. SETTING: University hospital, tertiary care center. PATIENT: A 21-year-old healthy man who had recently worked as a professional landscaper in the Albuquerque, New Mexico, metropolitan area developed fever, malaise, headache, and a stiff neck. MAIN OUTCOME MEASURES: Francisella tularensis cerebrospinal fluid culture, antibiotic sensitivity, transmission source, and outcome. RESULTS: The cerebrospinal fluid contained a lymphocytic pleocytosis, negative Gram stain, and F tularensis isolation with chloramphenicol and streptomycin antibiotic sensitivities. CONCLUSIONS: Although tularemia is uncommon and tularemic meningitis is rare in the United States, attention is drawn to the increasing number of cases in professional landscapers, the atypical cerebrospinal fluid picture, and unusual antibiotic sensitivities.
Authors:
Diedre M Hofinger; Luzma Cardona; Gregory J Mertz; Larry E Davis
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Archives of neurology     Volume:  66     ISSN:  1538-3687     ISO Abbreviation:  Arch. Neurol.     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-04-14     Completed Date:  2009-04-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372436     Medline TA:  Arch Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  523-7     Citation Subset:  AIM; IM    
Affiliation:
Medicine Service, New Mexico VA Health Care System, 1501 San Pedro Dr SE, Albuquerque, NM 87108, USA. dhofinger@salud.unm.edu
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Adult
Chloramphenicol / administration & dosage,  analogs & derivatives
Ciprofloxacin / administration & dosage
Diagnosis, Differential
Drug Therapy, Combination
Francisella tularensis* / drug effects
Humans
Infusions, Intravenous
Male
Meningitis / diagnosis*,  drug therapy
New Mexico
Occupational Diseases / diagnosis*,  drug therapy
Streptomycin / administration & dosage
Tularemia / diagnosis*,  drug therapy
United States
Chemical
Reg. No./Substance:
3544-94-3/chloramphenicol succinate; 56-75-7/Chloramphenicol; 57-92-1/Streptomycin; 85721-33-1/Ciprofloxacin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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