[Postsurgical meningitis caused by Pseudomonas aeruginosa: study of 15 cases and review of the literature].
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.
Rodríguez Guardado
A
A
Servicio de Medicina Interna, Hospital Central de Asturias, Oviedo.
Maradona Hidalgo
J A
JA
Asensi Alvarez
V
V
Cartón Sánchez
J A
JA
Pérez González
F
F
Arribas Castrillo
J M
JM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D016920:Meningitis, Bacterial / Q000382:microbiology*; D008875:Middle Aged; D011183:Postoperative Complications / Q000382:microbiology*; D011552:Pseudomonas Infections; D012189:Retrospective Studies