Case Report: Two Penicillin Resistant Pneumococcus Meningitis Cases

Abstract

Streptococcus pneumoniae is a major cause of meningitis in adults and for the treatment penicillin is used as a drug of choise. Penicillin resistant strains have been reported all over the world. In this paper, we have presented two cases of meningitis caused by S. pneumoniae that show intermediate resistance to penicillin. Both of the patients were male, had head trauma stories and their ages were 40 and 22 years old respectively. S. pneumoniae strains were isolated from cerebrospinal fluid sample of the first patient and blood sample of the other, and the minimal inhibitory concentrations (MICs) were found 0.6 μg/ml for penicillin by E test, however both of the strains were susceptible to ceftriaxone, cefotaxime and vancomycin. The patients were treated with intravenous ceftriaxone (4 gr/day) for 14 days and discharged with complete recovery and with no neurological complications. In conclusion, ceftriaxone is an alternative antibiotic for the therapy of meningitis caused by intermediate penicillin resistant S. pneumoniae strains.