Journal of the Formosan Medical Association
Volume 105, Issue 9 , Pages 756-759, 2006

Spontaneous Escherichia coli Meningitis Associated with Hemophagocytic Lymphohistiocytosis

  • Kuo-Hsuan Chang
    • ,
  • Rong-Kuo Lyu

      Affiliations

    • Corresponding Author InformationCorrespondence to: Dr Rong-Kuo Lyu, Section of Neuromuscular Diseases, Department of Neurology, Chang Gung Memorial Hospital, 199 Tung Hwa North Road, Taipei, Taiwan
  • Lok-Ming Tang

      Affiliations

    • Department of Neurology, Lo-Tung Pohai Hospital, Ilan, Taiwan

Section of Neuromuscular Diseases, Department of Neurology, Chang Gung Memorial Hospital and University Medical College, Taipei, Taiwan

Received 19 July 2005; received in revised form 30 August 2005; accepted 4 October 2005.

Article Outline

Spontaneous Escherichia coli meningitis has not been previously reported in association with hemophago-cytic lymphohistiocytosis (HLH). A previously healthy 72-year-old woman was admitted due to fever, nuchal rigidity, disturbed consciousness and splenomegaly. Anemia, thrombocytopenia and hyperfer-ritinemia developed on the 8th day of hospitalization. Cultures of cerebrospinal fluid and blood grew E. coli. Abundant macrophages overwhelmed erythrocytes in the bone marrow aspirate, confirming the presence of hemophagocytosis. E. coli meningitis was managed with a 40-day course of antibiotic treatment. However, the severity of anemia and thrombocytopenia progressed despite intensive transfusion therapy. The patient died of HLH on the 60th day of hospitalization.

Key Words:  Escherichia coli , hemophagocytosis , meningitis

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PII: S0929-6646(09)60204-7

doi:10.1016/S0929-6646(09)60204-7

Journal of the Formosan Medical Association
Volume 105, Issue 9 , Pages 756-759, 2006

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