ANAEROBIC MENINGITIS CAUSED BY PEPTOSTREPTOCOCCUS-MAGNUS AFTER HEAD AND NECK-SURGERY

Although anaerobic bacterial meningitis is uncommon, patients subjecte d to resection of head and neck malignancy appear at special risk. In this article, the authors report on a 72-year-old man in whom meningit is developed after extensive resection of the right sinuses for squamo us cell carcinoma; initial treatment consisted of intravenous vancomyc in and ceftazidime. Intravenous penicillin G was added after the fortu itous early finding of intracellular cocci in Wright-Giemsa stained ce rebral spinal fluid submitted for cell count. Cerebral spinal fluid cu ltures then grew out a pure culture of Peptostreptococcus magnus. The patient had a complete recovery, without neurologic sequelae, recurren ce of malignancy, or evidence of infection. Appropriate handling of ce rebral spinal fluid specimens is crucial to ensure the correct diagnos is when anaerobic organisms are suspected.