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Case Reports in Pulmonology
Volume 2011, Article ID 485952, 3 pages
Case Report

First Report of a Case of Pneumococcal Meningitis Which Did Not Respond to the Ceftriaxone Therapy despite the Isolated Organism Being Sensitive to This Antibiotic In Vitro

1Department of infectious disease, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
2Microbiology and Virology Research Center, Ghaem University Hospital and Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad 9188974645, Iran

Received 23 June 2011; Accepted 24 August 2011

Academic Editors: F. L. Fimognari and K. Watanabe

Copyright © 2011 Maryam Mojtabavi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


A 60-year-old man presented with pneumococcal meningitis which did not respond to the ceftriaxone therapy, in spite of in-vitro susceptibility (minimal inhibitory concentration of 0.016 μg/dLit) of the isolated organism to this antibacterial agent, although ceftriaxone is still the drug of choice for such pneumococcal meningitis. Review of published articles revealed no report of clinical resistance in organisms which were susceptible to the same antimicrobial agent in vitro. This alarming emergence of isolates with in vivo resistance should be considered and even could lead to a shift in the empirical antibiotic therapy for pneumococcal infections.