Journal Article

Risk Factors for Meningitis After Transsphenoidal Surgery

Maarten O. van Aken, Siem de Marie, Aart-Jan van der Lely, Ram Singh, Siem de Marie, J. Herbert van den Berge, Rene M. L. Poublon, Wytske J. Fokkens, Steven W. J. Lamberts and Wouter W. de Herder

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 25, issue 4, pages 852-856
Published in print October 1997 | ISSN: 1058-4838
Published online October 1997 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/515533
Risk Factors for Meningitis After Transsphenoidal Surgery

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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.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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