Kyeong Seob Shin1, Dong Ik Shin2, Woo Sub Shim3, Byeong Cheol Rim4, Il Hun Bae5, Seung Young Lee5, Dong Hee Ryu6, Eun Jung Kim7, Bo Ra Son1
Departments of 1Laboratory Medicine, 2Neurology, 3Otorhinolaryngology-Head and Neck Surgery, 4Neurosurgery, 5Radiology and 6Surgery, Chungbuk National University College of Medicine, 7Department of Pathology, Chungbuk National University Hospital, Cheongju, Korea
Streptococcus salivarius meningitis is very uncommon, and most cases are iatrogenic, occurring after invasive procedures such as spinal anesthesia or lumbar puncture etc.. Post-traumatic occurrence of this infection is especially rare. A 20-year-old man with a previous history of skull base fracture was seen at the emergency department with signs of acute bacterial meningitis. The CSF had a few gram positive cocci with neutrophilic pleocytosis, which were identified as S. salivarius by the Vitek system (bioMerioux, Inc., Hazelwood, MO, USA), rapid ID 32 Strep (bioMerieux, Marcy-l’Etoile, France) and 16S rRNA sequencing. The microorganism showed intermediate resistance to penicillin (MIC=0.25μg/mL) but was susceptible to cefotaxime (MIC=0.25μg/mL) and vancomycin (MIC= 0.75μg/mL). The patient was treated with ceftriaxone and vancomycin. He also had his CSF leakage repaired by an endoscopic approach. To our knowledge, this is the first case of S. salivarius meningitis reported in Korea. (Korean J Clin Microbiol 2009;12:92-96)