A case report of meningitis with failure of ceftriaxone therapy.

Background: is a gram-negative zoonotic organism that has the potential to cause devastating human infection. Historically, treatment with beta-lactams including penicillin and ceftriaxone has been effective.

Methods: We describe a complicated case of meningitis in a 70-year-old female following a superficial puncture wound from her dog's teeth.

Results: The case described here was complicated by seizures following treatment with ceftriaxone therapy. This case is also the first reported case of meningitis associated with moyamoya disease and fibromuscular dysplasia.

Conclusions: Physicians should be aware of the possibility of ceftriaxone-resistant and have a low threshold to broaden antimicrobial coverage in the absence of clinical improvement. We also raise the possibility of an association between vasculopathies and unusual infections like .