title: Complications of adenotonsillectomy: a case report of meningitis due to dual infection with nontypeable Haemophilus influenzae and Streptococcus pneumoniae, and a prospective study of the rate of postoperative bacteremia.
abstract: METHODS
  Bacterial meningitis is a rare complication of adenotonsillectomy. We present a case of meningitis due to nontypeable Haemophilus influenzae and Streptococcus pneumoniae after adenotonsillectomy. Pulsed-field gel electrophoresis patterns indicated that the oral cavity was the source of H. influenzae and S. pneumoniae isolated from the cerebrospinal fluid. BLOOD CULTURE STUDY: As bacteremia is thought to be one of the etiologies of meningitis, we prospectively investigated the rate of bacteremia as a complication of adenotonsillectomy. Of the 46 patients included in the study, mean age of five years old, 11 (24%) had positive blood cultures during the operation. H. influenzae was the commonest organism grown (seven cultures), three of seven produced beta-lactamase, followed by S. pneumoniae (one culture), H. parainfluenzae (one culture), Peptostreptococcus micros (one culture), and Veillonella spp. (one culture). The bacteria were composed of tonsil or adenoid surface cultures in eight of 11 patients (73%).
  
  
  CONCLUSIONS
  We present a rare case of meningitis complicating a adenotonsillectomy procedure, in a three years old boy. Meningitis is a rare complication of adenotonsillectomy, but bacteremia which may lead to meningitis occurs frequently, as the results.
authors.affiliation: Department of Pediatrics, Chiba Kaihin Municipal Hospital.
authors.forename: Junko
authors.initials: J
authors.lastname: Tanaka
authors.affiliation: Department of Pediatrics, Chiba Kaihin Municipal Hospital.
authors.forename: Tomomichi
authors.initials: T
authors.lastname: Kurosaki
authors.affiliation: Department of Otolaryngology, Chiba Kaihin Municipal Hospital.
authors.forename: Akiko
authors.initials: A
authors.lastname: Shimada
authors.affiliation: Department of Otolaryngology, Chiba Kaihin Municipal Hospital.
authors.forename: Yumi
authors.initials: Y
authors.lastname: Kameyama
authors.affiliation: Department of Infection Prevention and Control, Yokohama City University Hospital.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Mitsuda
authors.affiliation: Division of Control and Treatment of Infectious Diseases, Chiba University Hospital.
authors.forename: Naruhiko
authors.initials: N
authors.lastname: Ishiwada
authors.affiliation: Department of Pediatrics, Chiba University School of Medicine.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Kohno
mesh_terms: D000233:Adenoidectomy / Q000009:adverse effects*; D016470:Bacteremia / Q000453:epidemiology*; D002675:Child, Preschool; D006192:Haemophilus Infections / Q000453:epidemiology*; D006193:Haemophilus influenzae; D006801:Humans; D008297:Male; D016920:Meningitis, Bacterial / Q000453:epidemiology*; D011008:Pneumococcal Infections / Q000453:epidemiology*; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D014068:Tonsillectomy / Q000009:adverse effects*