Meningitis due to penicillin resistant Streptococcus pneumoniae occurring in a patient on long term ampicillin prophylaxis.

A patient with persistent dural fistula, CSF rhinorrhoea and a history of recurrent bacterial meningitis developed meningitis with a penicillin-resistant strain of Streptococcus pneumoniae while on prophylactic ampicillin. The microbiological aspects of management are discussed.