A Case of Perioperative Bacterial Meningitis Following Laparoscopic Restorative Proctocolectomy in a Patient with Ulcerative Colitis

Satoru Morita, Koji Okabayashi, Ryo Seishima, Kohei Shigeta, Masashi Tsuruta, Hirotoshi Hasegawa, Yuko Kitagawa

Research output: Contribution to journalArticlepeer-review

Abstract

Herein, we report a case of bacterial meningitis caused by Enterococcus faecium that was diagnosed following laparoscopic total proctocolectomy to treat ulcerative colitis. A 60-year-old man with refractory, active-phase ulcerative colitis was admitted and treated with laparoscopic total colectomy, ileal pouch-anal anastomosis, and ileostomy. The patient suffered from sepsis-associated disseminated intravascular coagulation during the perioperative period, and despite antibiotic treatment for differential diagnoses, including pneumonia and intra-abdominal infection, his remittent fever and disturbance of consciousness persisted. Sixty-three days after surgery, we performed head MRI and cerebrospinal fluid analysis, both of which indicated bacterial meningitis. Accordingly, after we treated the patient with targeted antibiotics for six weeks, his remittent fever and disturbance of consciousness dissipated. No evidence of bacterial meningitis was found in a subsequent head MRI or cerebrospinal fluid analysis. Perioperative bacterial meningitis following surgery for ulcerative colitis is, as in this case, extremely rare and difficult to diagnose.

Original languageEnglish
Pages (from-to)725-731
Number of pages7
JournalJapanese Journal of Gastroenterological Surgery
Volume53
Issue number9
DOIs
Publication statusPublished - 2020

Keywords

  • bacterial meningitis
  • total colectomy
  • ulcerative colitis

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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