Abstract
Infection is one of the common complications in dialysis patients, but cerebrospinal infections are relatively rare.
The present report records the first two cases of meningitis due to Klebsiella (K) pneumoniae in hemodialysis patients in Japan.
Case 1: A 36-year-old female was admitted for disturbance of conciousness eight years after beginning hemodialysis. Physical examination on admission revealed stupor and stiffness of the neck. In a direct smear of the CSF, Gram-negative bacilli were seen and the micro-organism was identified as K. pneumoniae. The patient received chemotherapy. She died three days after admission. Autopsy findings revealed meningitis due to K. pneumoniae.
Case 2: A 51-year-old female was admitted for disturbance of conciousness and high fever 7.5 years after beginning hemodialysis. Physical examination on admission revealed coma, fever of 40.7°C and 66mmHg in systolic blood pressure. She died 13 hours after admission. Autopsy findings revealed meningitis due to K. pneumoniae.
Since the incidence of attack by an opportunistic pathogen such as K. pneumoniae is always greater in compromised hosts such as dialysis patients, attention must be paid to the occurrence of opportunistic infections.
