Nosocomial Providencia stuartii Meningitis: A Case Report

Providencia stuartii is an opportunistic pathogen and may cause health-care infections. They mostly cause urinary-catheter-related infections. Meningitis associated with this bacterium is extremely rare. Here we report a P. stuartii meningitis in a patient with external lumbar drainage in the neurosurgery unit. A fifty-seven-year old male patient was admitted to the neurosurgery department with headache and confusion. There was a subarachnoidal hemorrhage on computerized tomography (CT) scan and he was transferred to the intensive care unit. His neurological evaluation showed a grade 3a mental status according to the Yasargil classification and a Glasgow coma scale of 14. The CT-angiography and digital subtraction angiography revealed multiple arterial aneurisms. Coil embolization was made for three of the aneurisms. Since the patient had hydrocephalus on his follow-up on the 14th day, a lumbar drainage (LD) catheter was inserted. Daily cerebrospinal fluid (CSF) analyses were performed. On the 7th day of the LD the CSF findings revealed meningitis and P. stuartii was revealed from the three subsequent CSF cultures. The LD was removed and daily lumbar punctures and CSF cultures were performed. On the 7th day of his antibiotic therapy his laboratory findings returned to normal levels. Following CSF cultures were negative. The antibiotic therapy continued to 21 days. His meningitis was cured. To the authors’ knowledge there were only two patients with P. stuartii meningitis in the literature and this is the third one. doi:10.4021/jnr105e