Mixed Bacterial Meningitis Due to Streptococcus Pneumoniae and Mycobacterium Tuberculosis

187 Correspondence to: Alexandru Crisan, 73 S.Barnutiu Str., Timisoara, Tel.0723919382 Email: [email protected] SUMMARY Generally meningitis with mixed etiology is secondary to underlying diseases (nearby infections of sinuses, ears), post-trauma or penetration of the subarachnoid space (spinal tap, neurosurgery), appears at youngsters and immunodepressed persons. The authors present the case of a 17 years old male who developed pneumococcal meningitis simultaneously with tuberculous meningitis. Diagnosis was established upon clinical and laboratory criteria. Diagnosis of pneumococcal meningitis was sustained by direct microscopic exam of smear, that showed encapsulated gram-positive diplococci and the latex particle agglutination test that was positive for Streptococcus pneumoniae. Diagnosis of tuberculous meningitis was established on direct exam of smear of pellicle and positive cultures for Koch bacillus. His evolution was difficult with triventricular non aggressive hydrocephalus, although he was treated correctly with antibiotics (meropenem, rifampin, isoniazid, pyrazinamide, ethambutol, streptomycin), corticosteroids and cultures became negative afterwards. As the number of immunodepressed subjects is bigger, the authors stress the existence of this association (pneumoncoccus+Koch bacillus ) as cause of acute bacterial meningitis.