Meningitis due to multiple-resistant penicillin- and cefotaxime-intermediate Streptococcus pneumoniae in a German child after bone marrow transplantation

Infection. 2003 Dec;31(6):425-7. doi: 10.1007/s15010-003-3134-1.

Abstract

The incidence of infection with penicillin-non-susceptible Streptococcus pneumoniae is increasing rapidly worldwide. Spain and France are highly affected, whereas the level of penicillin resistance in Germany, Italy, The Netherlands and Scandinavia is low. We report a lethal episode of meningitis due to penicillin- and cefotaxime-intermediate S. pneumoniae in a 7-year-old, allogene bone marrow transplanted German boy, 5 weeks after a holiday in Spain. Three days prior to the infection the patient showed good performance status. He was in complete remission without signs of graft-versus-host disease (GVHD). He died on day 341 post bone marrow transplant (BMT), 2 days after the onset of meningitis. Penicillin-non-susceptible S. pneumoniae should be regarded as a potential infectious agent even in countries with a low prevalence of resistance.

Publication types

  • Case Reports

MeSH terms

  • Bone Marrow Transplantation / adverse effects*
  • Bone Marrow Transplantation / methods
  • Cefotaxime / pharmacology
  • Cephalosporin Resistance*
  • Child
  • Disease Progression
  • Drug Resistance, Multiple, Bacterial
  • Fatal Outcome
  • Germany
  • Humans
  • Male
  • Meningitis, Pneumococcal / drug therapy*
  • Meningitis, Pneumococcal / microbiology
  • Microbial Sensitivity Tests
  • Penicillin Resistance*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / diagnosis
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy
  • Risk Assessment
  • Streptococcus pneumoniae / drug effects*
  • Streptococcus pneumoniae / isolation & purification

Substances

  • Cefotaxime