Abstract Ref Number = APCP1100
BACTERIAL MENINGITIS CAUSED BY PSUEDOMONAS STUTZERI IN A 6 YEARS OLD MALE CHILDREN
I Gusti Ngurah Made Suwarba,Sandi Parwata
Pediatrics Department Medical Faculty Udayana University Denpasar Bali Indonesia
Background : Bacterial meningitis due to Pseudomonas Stutzeri infection is a rare cases in children. Pseudomonas Stutzeri is the community bacteria that can be found in marine water, soil, and wastewater treatment. Predisposing risk factor for Pseudomonas Stutzeri infection can be categorized as follows : 1). Previous surgery or procedure (implying probable nosocomial acquisition), with or without foreign body; 2). Immunocompromise, 3). Immunocompromise and previous procedure, 4). Previous trauma or superficial infection, with or without possible nosocomial contamination. Pseudomonas stutzeri infection have been reported in association with bacteremia/septicemia; bone infection, i.e., fracture infection, joint infection, osteomyelitis, and arthritis and meningitis.
Case Presentation Summary : A 6 years olds complained with decreased of consciousness since 1 day ago, headache since 2 days ago, and fever 4 days before hospitalized. There was no seizure complained. He was get head trauma on 1 month ago, the head trauma caused depressed calvarian bones and got wound treatment in primary care.Physical examination revealed somnolen consciousness, positive meningeal sign, normal muscle power and tones, increased physiogical reflexes, and depressed on right calvarian bones . From CSF analysis showed normal values and showed mononuclear dominancies. Complete blood test showed normal values. Mannitol was administered for 3 days but increasing in consciousness. Repeated CSF analysis after administered of mannitol for 3 days showed normal values. CSF culture showed positive culture of Pseudomonas Stutzeri and sensitive with ceftazidime. After 2x24 hours of ceftazidime and dexamethasone administration, patient showed increasing of consciousness and reseolved in meningeal sign. Ceftazidime administration continued until 14 days and patient discharge after it.
Learning Points/Discussion : Pseudomonas Stutzeri infection in CSF is are rare cases. History of trauma and inappropriate wound care can be a risk factor to make bacterial meningitis. Normal CSF values showed percontinuitatum infection
Keywords: bacterial meningitis pseudomonas stutzeri children