Immunopathol Persa. 2018;4(2):e22-e22.
doi: 10.15171/ipp.2018.22
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Case Report

A case of pneumococcal meningitis due to fall from height 

Mohammad Hossein Dehghan 1, Enayatollah Kalantar 2, Parviz Fallah 3, Sadegh Saedi 3, Mojgan Mirzaei 3, Mohsen Arabi 4, Fatemeh Rahimi 4, Ali Ehsan Heidari 3 *

1 Department of Biochemistry, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
2 Department of Microbiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
3 Medical Laboratory, Rajaei Hospital, Alborz University of Medical Sciences, Karaj, Iran
4 Department of Education, Rajaei Hospital, Alborz University of Medical Sciences, Karaj, Iran
Correspondence to Ali Ehsan Heidari, Ph.D Email: aliehsan2001@yahoo.com

Abstract

Meningococcal disease is a serious infection that may progress quickly, even after proper treatment has started. We here report a case of adult patients with pneumococcal meningitis which was due to fall from height. A 28-year-old man which was fallen from a height presented to the emergency ward complaining of right elbow pain and head wound. His cerebrospinal fluid (CSF) was dark, yellow and semi-clear. Brain CT scan showed an old contusion frontal lobe. CSF cultures grew numerous colonies of Streptococcus pneumoniae. Antibiotic susceptibility was performed for the isolated S. pneumonia. Vancomycin was administered immediately. Patient clinical state and signs of ongoing infection implied the possibility of a resistant pneumococcus. Then meropenem was added to the antimicrobial regimen which resulted in significant clinical improvement. Like other studies, this case suggests that pneumococcal meningitis should be considered in adult patients. Additionally the presence of gram-positive cocci in the CSF is associated with high mortality and morbidity. Treatment of this case with meropenem resulted in significant clinical improvement and subsequently improved the patient’s condition. Therefore, antimicrobial therapy should be started immediately if there are any signs of meningitis.
Citation: Dehghan MH, Kalantar E, Fallah P, Saedi S, Mirzaei M, Arabi M, et al. A case of pneumococcal meningitis due to fall from height. Immunopathol Persa. 2018;4(2):e22. DOI:10.15171/ ipp.2018.22.
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