Pneumoencephalomeningitis secondary to infected lumbar arthrodesis with a fistula: a case report.
Pneumocephalus associated with spinal problems is very rare. Association with encephalomeningitis secondary to a fistula after an infected elective lumbar spine fusion has not been previously reported. The authors report a case in which the clinical onset of pneumoencephalomeningitis occurred after an airplane flight. CT-scan and lumbar puncture were used to make diagnosis; the treatment was based on parenteral antibiotics. The symptoms and signs of infection and neurological deficit resolved but the fistula remained. Diagnosis in such cases must be based upon CT-scan and lumbar puncture. Treatment should consist of systemic antibiotic therapy. Surgical management of infection and fistula is desirable, should the status of the patient allow such a treatment. In any case, as airplane flights in such cases may predispose to pneumocephalus, patients with an infected CSF fistula should avoid airplane flights until the problem is solved.
Guerado
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Department of Orthopedic and Trauma Surgery, Hospital Costa del Sol, University of Malaga, 29600 Marbella, Malaga, Spain. eguerado@hcs.es
Peña
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D000401:Aircraft; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002555:Cerebrospinal Fluid; D005260:Female; D005402:Fistula / Q000150:complications / Q000209:etiology*; D006801:Humans; D008161:Lumbosacral Region / Q000601:surgery; D016920:Meningitis, Bacterial / Q000188:drug therapy / Q000209:etiology*; D008875:Middle Aged; D011007:Pneumocephalus / Q000209:etiology* / Q000382:microbiology; D013118:Spinal Cord Diseases / Q000150:complications / Q000209:etiology*; D013123:Spinal Fusion / Q000009:adverse effects*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents