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Post-traumatic Acinetobacter baumannii Meningitis Following Penetrating Trauma: A Case Report
Wilhelm Hansen1,2, Ingrid Dreyer2, Lourens Botes2
1Department of General Surgery, University of the Witwatersrand, Johannesburg, ZAF.
Abstract:
This report details the case of a 29-year-old male patient who presented at a tertiary-level trauma centre with multiple stab wounds to the face, chest, and back. Despite not undergoing surgical intervention or exhibiting any apparent cerebrospinal fluid (CSF) leakage during the initial evaluation. The patient's condition deteriorated, with subsequent cultures from CSF and blood confirmed extensively drug-resistant (XDR) Acinetobacter baumannii (A. baumannii) meningitis. Imaging revealed a spinal canal breach with abscess formation, necessitating targeted antibiotic therapy and neurosurgical debridement. This case highlights the potential challenges in diagnosing and managing A. baumannii meningitis, especially in trauma patients. Early recognition of risk factors, thorough clinical examination and multidisciplinary care were crucial for clinical improvement. The case also highlights the critical need for robust infection control measures to address the rising threat of XDR pathogens in healthcare settings.
Insights
A trauma patient developed extensively drug-resistant Acinetobacter baumannii meningitis after stab wounds. Prompt diagnosis and multidisciplinary care were vital for recovery, underscoring infection control needs.
Area of Science:
- Infectious Diseases
- Neurosurgery
- Trauma Care
Background:
- Acinetobacter baumannii is a significant nosocomial pathogen, increasingly exhibiting extensive drug resistance (XDR).
- Meningitis in trauma patients presents diagnostic and therapeutic challenges, particularly with XDR bacterial strains.
Observation:
- A 29-year-old male with multiple stab wounds developed XDR Acinetobacter baumannii meningitis despite no initial signs of cerebrospinal fluid (CSF) leakage.
- Imaging revealed a spinal canal breach and abscess formation, necessitating aggressive treatment.
Findings:
- Cultures confirmed XDR Acinetobacter baumannii in both CSF and blood.
- Targeted antibiotic therapy and neurosurgical debridement were critical for the patient's clinical improvement.
Implications:
- This case underscores the importance of early recognition and multidisciplinary management for XDR A. baumannii meningitis in trauma settings.
- Highlights the need for stringent infection control protocols to combat the growing threat of XDR pathogens in healthcare environments.
