All issues > Volume 22(7); 1979

Case Report

J Korean Pediatr Soc. 1979;22(7):525-531. Published online July 15, 1979.

Gentamicin-resistant Pseudonomas Aeruginosa Menigitis.

Chung Il Noh, Yong Soo Yoon, Hyung Ro Moon, Chang Yee Hong

¹Department of Pediatrics, College of Medicine, Seoul National University, Korea.

Abstract

We have treated 4-year-old with amikacin and rifampin, who suffered from bacterial meningitis due to gentamicin-resistant Pseudomonas aeruginosa. There was no complication during treatment. Even though we didint check audiometry and BUN and/or creatinine, urinalysis was normal and physical examination revealed no abnormalities. He had been treated fora about 3 months with various antibiotics including gentamicin, intravascular and intrathecal, and carbenicillin. Fever, headache and meningeal irritation signs recurred intermittently in spite of continuous treatment. The culture of the CSF showed P. aeruginosa, which initially was sensitive to gentamicin but became resistant to it. The computed tomography of the brain showed diffuse ventricular dilatation with no abnormal shadow in the cerebral hemisphere and posterior fossa. So we decided to administer rifampin 300mg P.O. daily and amikacin 120mg I.M. daily. Faver became normalized after 14 days of treatment. Neurologic examination was normal. The culture of CSF at that time revealed no growth of P. areugicnosa. He was discharged after 40 days of treatment. As mentioned above, no problem due to amilacin alone or amikacin with refampin. Until now, relationship between amikacin and refampin was not clear. Amikacin alone may be efficient to gentamicin-resistant P. aeruginosa infection. But because amikacin was given through intramuscular route in stead of intrathecal route and daily dosage of amikacin was 8mg/kg in stead of 15mg/kg, which was permissible dosage, the role of rifampin might not be neglected as trivial, even though there was no proof that rifampin was effective against Pseudomonase areuginosa espercially which was gentamicin-resistrant.

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