[Postsurgical meningitis caused by Pseudomonas aeruginosa: study of 15 cases and review of the literature].

Autor:	Rodríguez Guardado A; Servicio de Medicina Interna, Hospital Central de Asturias, Oviedo., Maradona Hidalgo JA, Asensi Alvarez V, Cartón Sánchez JA, Pérez González F, Arribas Castrillo JM
Jazyk:	Spanish; Castilian
Zdroj:	Revista clinica espanola [Rev Clin Esp] 2000 Jun; Vol. 200 (6), pp. 301-4.
DOI:	10.1016/s0014-2565(00)70641-2
Abstrakt:	Objective: Pseudomonas aeruginosa meningitis is a rare condition which is usually associated with pathology in the ORL field, neurosurgery or local neurologic manipulations. The characteristics, epidemiology, and course of this entity were determined. Methods: Fifteen episodes of nosocomial postsurgical Pseudomonas aeruginosa meningitis occurred between 1989 and 1996 were retrospectively analyzed. Results: A previous cranioencephalic trauma was recorded in 46.6% of patients. The portals of entry included: intraventricular catheter (IC) (12 cases), CSF fistula (2 cases), and craniotomy (1 case). In five occasions (41.6%) the microorganism was also recovered from the intraventricular catheter. Once culture results were available, therapy with active drugs against Pseudomonas was instituted and in 7 occasions was accompanied by the removal of IC. Eight patients eventually cured and two patients relapsed. The absence of cure was significantly associated with non-removal of the IC (p < 0.01). The infection resulted in death in 26.6% of patients. Conclusions: Postsurgical Pseudomonas aeruginosa meningitis is an entity of growing relevance. It is associated with relevant morbi-mortality. Catheter removal is essential to obtain a favorable outcome.
Databáze:	MEDLINE
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