title: Causes of infections in penetrating head wounds in the Iran-Iraq War.
abstract: Factors seemingly influential in postoperative central nervous system infections were evaluated in 379 patients who sustained missile wounds to the head during the Iran-Iraq War. The mean wound age was 49 hours. The site of injury and presence of retained bone and/or shell fragments did not have a significant effect on infection rate. Thirty-three of 379 patients developed cerebrospinal fluid (CSF) fistulas of which 12 (36%) were associated with infection. The infection rate was 6 of 346 (1.7%) in the absence of CSF leaks. There was a statistically significant association between CSF fistula and infection. All 6 positive cultures in patients with CSF fistulas were gram-negative. Thirty-two patients died during the study, a mortality rate of 8.4%. The mortality rate from infection was 1.8%. Two hundred seventy-seven of 347 patients were followed for a mean of 22 +/- 17 months during which time 2 patients were readmitted with central nervous system infections, both due to CSF leakage. CSF fistulas were the main predisposing factor in postdebridement central nervous system infections in this study.
authors.affiliation: Department of Neurosurgery, Shiraz University Medical School, Nemazee Hospital, Iran.
authors.forename: B
authors.initials: B
authors.lastname: Aarabi
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy / Q000209:etiology*; D001927:Brain Diseases / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D001930:Brain Injuries / Q000150:complications*; D002555:Cerebrospinal Fluid; D005402:Fistula / Q000150:complications*; D006801:Humans; D007492:Iran; D007493:Iraq; D014950:Wounds, Penetrating / Q000150:complications*
chemical_list: D000900:Anti-Bacterial Agents