title: Risk factors for meningitis after transsphenoidal surgery.
abstract: 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.
authors.affiliation: Department of Internal Medicine, University Hospital Rotterdam, The Netherlands.
authors.forename: M O
authors.initials: MO
authors.lastname: van Aken
authors.forename: S
authors.initials: S
authors.lastname: de Marie
authors.forename: A J
authors.initials: AJ
authors.lastname: van der Lely
authors.forename: R
authors.initials: R
authors.lastname: Singh
authors.forename: J H
authors.initials: JH
authors.lastname: van den Berge
authors.forename: R M
authors.initials: RM
authors.lastname: Poublon
authors.forename: W J
authors.initials: WJ
authors.lastname: Fokkens
authors.forename: S W
authors.initials: SW
authors.lastname: Lamberts
authors.forename: W W
authors.initials: WW
authors.lastname: de Herder
mesh_terms: D000658:Amoxicillin / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D006801:Humans; D015994:Incidence; D016920:Meningitis, Bacterial / Q000134:cerebrospinal fluid / Q000453:epidemiology / Q000209:etiology*; D009300:Nasal Septum / Q000382:microbiology; D010406:Penicillins / Q000627:therapeutic use; D011183:Postoperative Complications / Q000134:cerebrospinal fluid / Q000453:epidemiology; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D012307:Risk Factors; D013100:Sphenoid Bone / Q000601:surgery*; D015524:Sphenoid Sinusitis / Q000150:complications / Q000601:surgery; D013211:Staphylococcus aureus
chemical_list: D010406:Penicillins; D000658:Amoxicillin