Penicillin-resistant Streptococcus mitis as a cause of septicemia with meningitis in febrile neutropenic children.

摘要: Purpose: The purpose of this report is to emphasize the importance occurrence Streptococcus mitis meningitis in febrile neutropenic children with hematopoietic malignancy. Patients and Methods: Symptoms sepsis (fever, headache, changes mental status) were seen three patients who severely undergoing cytotoxic chemotherapy for CNS relapse their underlying malignancy (acute lymphoblastic leukemia (ALL), n = 2; Burkitt's lymphoma, 1). Chemotherapy had included cytosine arabinoside administered 7-14 days prior presenting meningitis. All buccal mucositis or sinusitis. Blood cultures CSF showed S. resistant penicillin but sensitive vancomycin. Vancomycin, at a dosage 60 mg/kg/day maximize levels antibiotic, was all children. Results: Two recovered from meningitis; recovery associated an improvement peripheral granulocyte counts. One patient, remained neutropenic, died despite being treated both intravenous intraventricular Conclusion: Physicians caring are need be aware risk occurring sepsis. Early treatment high dosages vancomycin (60 mg/kg/day) attempt limit duration neutropenia important factors outcome such patients.