Journal Article

Failure of Treatment for Chronic <i>Mycobacterium abscessus</i> Meningitis Despite Adequate Clarithromycin Levels in Cerebrospinal Fluid

Calin V. Maniu, Walter C. Hellinger, Sou-Yie Chu, Robert Palmer and Salvador Alvarez Elcoro

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 33, issue 5, pages 745-748
Published in print September 2001 | ISSN: 1058-4838
Published online September 2001 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/322633
Failure of Treatment for Chronic Mycobacterium abscessus Meningitis Despite Adequate Clarithromycin Levels in Cerebrospinal Fluid

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We report a case of posttraumatic meningitis due to Mycobacterium abscessus, treated initially with oral clarithromycin and intravenous amikacin plus intrathecal amikacin. Despite cerebrospinal fluid (CSF) levels of clarithromycin and amikacin in excess of their in vitro minimum inhibitory concentrations for the organism, the CSF cultures remained continuously positive for M. abscessus. To our knowledge, this is the first documented case of M. abscessus meningitis and the first report of measured CSF levels of clarithromycin in a patient with meningitis, showing that even therapeutic CSF levels of clarithromycin and amikacin might not be successful in eradicating M. abscessus meningitis.

Journal Article.  1974 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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