Metronidazole therapy of anaerobic bacteremia, meningitis, and brain abscess

Abstract

Four patients with Bacteroides fragilis bacteremia, 1 patient with a brain abscess due to Bacteroides sp., Fusobacterium naviforme and Peptostreptococcus sp. and an infant with Bacteroides sp. ventriculitis and meningitis were treated with metronidazole. In all cases the anaerobic pathogens were eradicated. Of the 6 patients, 5 recovered. One patient with leukemia in whom B. fragilis bacteremia was eradicated by metronidazole treatment subsequently died of Pseudomonas aeruginosa bacteremia. Ventricular fluid and serum concentrations of metronidazole were determined in the case of meningitis and are reported.