title: Chemical meningitis following cerebellopontine angle tumor surgery.
abstract: OBJECTIVE
  Postoperative chemical meningitis mimics bacterial meningitis, complicating the diagnosis until results of cerebrospinal fluid (CSF) cultures can be obtained. We analyzed clinical and laboratory data from a series of 1146 patients to identify findings that could exclude bacterial meningitis.
  
  
  METHODS
  We reviewed the charts of patients who developed meningitis after cerebellopontine angle surgery. Lumbar puncture data from asymptomatic postoperative patients were our control.
  
  
  METHODS
  Clinical symptoms, CSF profiles, and serum white blood cell (WBC) counts were compared between patients with chemical meningitis, bacterial meningitis, and asymptomatic patients.
  
  
  RESULTS
  The incidence of meningitis in our series of 1146 patients was 4.54 percent; 0.87 percent was culture-proven bacterial meningitis. The patients with bacterial meningitis had significantly higher CSF and serum WBC counts, and lower CSF glucose. The major difference between asymptomatic patients and those with chemical meningitis was the significantly lower ratio of CSF WBCs to red blood cells (RBCs) in asymptomatic patients.
  
  
  CONCLUSIONS
  Patients with mild CSF leukocytosis and normal CSF glucose without high serum WBC counts or focal neurological deficits may be treated for chemical meningitis.
authors.affiliation: Department of Otolaryngology, Vanderbilt University Medical Center, Nashville, TN 37232, USA. Gabriela.sanchez@vanderbilt.edu
authors.forename: Gabriela B
authors.initials: GB
authors.lastname: Sanchez
authors.forename: David M
authors.initials: DM
authors.lastname: Kaylie
authors.forename: Matthew R
authors.initials: MR
authors.lastname: O'Malley
authors.forename: Robert F
authors.initials: RF
authors.lastname: Labadie
authors.forename: C Gary
authors.initials: CG
authors.lastname: Jackson
authors.forename: David S
authors.initials: DS
authors.lastname: Haynes
mesh_terms: D006801:Humans; D007958:Leukocyte Count; D008582:Meningitis, Aseptic / Q000209:etiology*; D016920:Meningitis, Bacterial / Q000175:diagnosis; D009464:Neuroma, Acoustic / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000175:diagnosis; D012189:Retrospective Studies