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Abstract
Acinetobacter baumannii infections have become significant pathogen in hospitalized patients, especially in the intensive care unit setting. Community-acquired Acinetobacter meningitis in adults is a very rare infection of the central nervous system. Most community-acquired Acinetobacter infections have been reported from countries with a tropical or subtropical climate. Acinetobacter infections mainly affect patients with some form of comorbidity and are also associated with heavy smoking and excess alcohol consumption. In our case, a 62-year-old male patient with DM, hypertension, and excess alcohol consumption developed meningitis. Bulging membrane and inflammation were observed in the right ear. A. baumannii meningitis was confirmed by blood, CSF, and ear discharge culture. The patient was treated effectively with meropenem for 21 days. After antibiotic treatment, follow-up cultures of CSF, blood, and ear discharge showed a negative result, and the CSF cell profile was normalized. However, the patient died of recurrent pneumonia on hospital day 45. We report on a case of community-acquired Acinetobacter meningitis in an adult in Korea.
Figures and Tables
Figure 1
Brain CT shows acute otitis media and mastoiditis, right (arrow). Opacified air cells and fluid are identified in the middle ear and mastoid.
Figure 2
Gram stain on CSF shows gram negative bacilli (arrow). (H&E stain, ×1,000 Cerebrospinal fluid).
Table 1
Based on Culture Tests for Blood, CSF, and Otorrhea, A. baumannii was Identified. Results of the Sensitivity Test
Table 2
Review of Reported Cases of Community-acquired Acinetobacter Infection in South Korea
N/D, no data
aOne case of Asian Network for Surveillance of Resistant Pathogens (ANSORP) Study Group community-acquired pneumonia caused by gram-negative bacilli.
bThe patient was diagnosed as having multiple rib fractures and hemothorax, and was found dead in his house three days later. At autopsy, the pneumothorax test showed a positive result, due to pleural adhesion and cavitary abscess from A. baumannii pneumonia.
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