Risk factors for meningitis after transsphenoidal surgery
| Autor: | S. W. J. Lamberts, J. H. Van Den Berge, W. W. de Herder, R. Singh, S. de Marie, R. M. L. Poublon, W. J. Fokkens, A. J. van der Lely, M. O. van Aken |
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| Přispěvatelé: | Internal Medicine, Medical Microbiology & Infectious Diseases, Neurosurgery, Otorhinolaryngology and Head and Neck Surgery, Other departments |
| Jazyk: | angličtina |
| Rok vydání: | 1997 |
| Předmět: |
Microbiology (medical)
medicine.medical_specialty Staphylococcus aureus medicine.medical_treatment Penicillins Preoperative care Meningitis Bacterial Postoperative Complications Risk Factors Sphenoid Bone medicine Humans Nasal Septum Randomized Controlled Trials as Topic Retrospective Studies Transsphenoidal surgery rhinorrhea Cerebrospinal fluid leak business.industry Sphenoid Sinusitis Incidence Amoxicillin Antibiotic Prophylaxis medicine.disease Cerebrospinal Fluid Rhinorrhea Surgery Infectious Diseases medicine.anatomical_structure Paranasal sinuses Anesthesia medicine.symptom Nasal vestibule business Meningitis |
| Zdroj: | Clinical Infectious Diseases, 25, 852-856. Oxford University Press Clinical infectious diseases, 25(4), 852-856. Oxford University Press |
| ISSN: | 1058-4838 |
| Popis: | To evaluate possible risk factors for meningitis, we retrospectively reviewed 228 transsphenoidal operations (in which a standard regimen of amoxicillin prophylaxis was used) for sellar pathology. The incidence of meningitis was 3.1% (seven of 228 cases). Cultures of preoperative specimens from the anterior nasal vestibule in three of seven patients yielded Staphylococcus aureus, but none of these patients developed S. aureus meningitis. Two of three patients with significant preoperative paranasal sinus abnormalities developed meningitis compared with only five of 225 patients without significant paranasal sinus abnormalities (P < .005). Three of 22 patients with intraoperative cerebrospinal fluid (CSF) leakage developed meningitis compared with four of 206 patients without intraoperative CSF leakage (P < .05). Six of seven patients with postoperative CSF rhinorrhea and only one of 221 patients without postoperative CSF rhinorrhea developed meningitis (P < .00001). In conclusion, postoperative CSF leakage is an important risk factor for meningitis after transsphenoidal surgery. Cultures of preoperative specimens from the anterior nasal vestibule did not have any predictive value in our study. |
| Databáze: | OpenAIRE |
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