Infectious Complications after Neurosurgery: Mainly Focusing on Ventriculitis and Meningitis

Jin-Hong Yoo

doi:10.3947/ic.2011.43.3.229

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Yoo: Infectious Complications after Neurosurgery: Mainly Focusing on Ventriculitis and Meningitis

Review Article

Infection & Chemotherapy

Infection & Chemotherapy 2011; 43(3): 229-233.

Published online: 29 June 2011

DOI: https://doi.org/10.3947/ic.2011.43.3.229

Infectious Complications after Neurosurgery: Mainly Focusing on Ventriculitis and Meningitis

Jin-Hong Yoo

Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea.

Correspondence to Jin-Hong Yoo, M.D. Division of Infectious Disease, Department of Internal Medicine, Bucheon St. Mary's Hospital, 2 Sosa-dong, Wonmi-gu, Bucheon 420-717, Korea. Tel: +82-1577-0675, Fax: +82-32-340-2669, jhyoo@catholic.ac.kr

Received 16 April 2011 Accepted 16 April 2011

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Ventriculitis and nosocomial meningitis are major infectious complications after neurosurgery. Determining whether fever after neurosurgery is infectious origin or not should be meticulously performed. Cell index >5 could be a reliable parameter for the decision to empirical treatment before microbiological documentation. Antimicrobials should be prudently chosen on the basis of risk factors (craniotomy, ventricular catheterization, trauma such as basal skull fracture) and of the pharmacokinetic properties along with blood-brain-barrier (BBB) permeability. Antimicrobials which have poor permeability to the BBB, glycopeptide as an example, could be administered via intrathecal route. If microbiological documentation is obtained after empirical treatment, the regimen should be adjusted according to the result of culture and sensitivity.

Keywords: Ventriculitis, Meningitis, Intrathecal, Cell index

Figures and Tables

Figure 1

Diagram for the decision making in the management of suspected/confirmed nosocomial meningitis and ventriculitis.

Table 1

Recommendations for Empirical Regimen of Antimicrobials for Nosocomial Bacterial Meningitis/ventriculitis according to Risk Factors

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