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A 39-year-old female with insulin-dependent diabetes mellitus developed Rhizopus infection of the maxillary sinus. Subsequent to successful treatment with amphotericin B and surgical debridement, she developed purulent meningitis due to a mucoid strain of Pseudomonas aeruginosa. Analysis of cerebrospinal fluid documented the presence of a uronic acid polymer at a concentration of 40 micrograms/ml. In spite of parenteral and intrathecal antibiotic therapy, the patient died. This case illustrates that mucoid strains of P. aeruginosa may result in fatal infection and that alginate capsule is produced in vivo in humans.

Demonstration of uronic acid capsular material in the cerebrospinal fluid of a patient with meningitis caused by mucoid Pseudomonas aeruginosa