Summary
Meningitis is rarely caused byKlebsiella ozaenae, a colonizer of the oral and nasopharyngeal mucosa. We describe two patients withK. ozaenae meningitis. Both patients suffered from a primary disease of the nasopharyngeal pathway; one had nasopharyngeal carcinoma and the other ozena. Review of the English-language literature from 1966 to the present revealed only two cases ofK. ozaenae meningitis; pneumonia and hyperglycemia were noted in one patient and otitis media, sinusitis and diabetes mellitus in the other. All these four patients were over 50 years old. Of the four patients, two treated with third-generation cephalosporins recovered whereas one of the two treated with chloramphenicol died. One patient who died had a positive blood culture forK. ozaenae. Blood culture was positive in only one of the three survivors. Whether chloramphenicol should be replaced by a third-generation cephalosporin and whether blood culture indicates a poor prognosis inK. ozaenae meningitis remain to be determined.
Zusammenfassung
Klebsiella ozaenae, ein Kommensale der oralen und nasopharyngealen Schleimhaut, löst nur selten eine Meningitis aus. Wir berichten über zwei Fälle vonK. ozaenae-Meningitis. Beide Patienten litten an einer primären Erkrankung im Nasopharyngealbereich. Einer hatte ein nasopharyngeales Karzinom, einer Ozaena. In der englischsprachigen Literatur fanden sich seit 1966 nur zwei Fälle von Meningitis durchK. ozaenae. Bei einem Patienten bestand eine Pneumonie und Hyperglykämie, beim anderen, ebenfalls einem Diabetiker, Otitis media and Sinusitis. Alle vier Patienten waren älter als 50 Jahre. Beide Patienten, die mit Cephalosporinen der dritten Generation behandelt wurden, überlebten, einer der beiden mit Chloramphenicol behandelten Patienten verstarb. Bei dem Verstorbenen wurdeK. ozaenae in der Blutkultur nachgewiesen. Unter den drei Überlebenden wies nur einerK. ozaenae in der Blutkultur auf. Ob Chloramphenicol durch ein Cephalosporin der dritten Generation ersetzt werden sollte und ob eine positive Blutkultur ein schlechtes prognostisches Zeichen für dieK. ozaenae-Meningitis darstellt, kann derzeit nicht beantwortet werden.
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Tang, L.M., Chen, S.T. Klebsiella ozaenae meningitis: Report of two cases and review of the literature. Infection 22, 58–61 (1994). https://doi.org/10.1007/BF01780771
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DOI: https://doi.org/10.1007/BF01780771