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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
07:43

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Streptococcus pneumoniae meningo-encephalitis after trans-sphenoidal surgery: a case report

B Bakar1, I Hakki Tekkok

  • 1Department of Neurology, Kirikkale University Faculty of Medicine, Kirikkale, Turkey. bulentbanrs@yahoo.com

Acta Chirurgica Belgica
|December 10, 2009
PubMed

Insights

A rare case of Streptococcus pneumoniae meningoencephalitis after pituitary surgery highlights infection risks. This suggests routine antibiotic prophylaxis may not prevent severe post-operative surgical infections.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Neurosurgery

Background:

  • Meningismus and meningitis are known complications following pituitary surgery.
  • Trans-sphenoidal surgery is a common approach for pituitary adenomas.

Observation:

  • A 56-year-old male presented with blurred vision, post-trans-sphenoidal surgery.
  • Within 48 hours, he developed hyperpyrexia, confusion, and lethargy.

Findings:

  • Cerebrospinal fluid cultures confirmed Streptococcus pneumoniae meningitis.
  • Magnetic resonance imaging revealed persistent frontal lobe changes.

Implications:

  • This case represents the first reported instance of Streptococcus pneumoniae meningoencephalitis after trans-sphenoidal surgery.
  • It questions the absolute efficacy of peri-operative antimicrobial chemoprophylaxis in preventing serious post-surgical infections.

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