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Updated: Jul 1, 2026
Diagnosis and Surgical Treatment of Human Brucellar Spondylodiscitis
Published on: May 23, 2021
First reported mortality from XDR Acinetobacter Baumannii Meningitis following posterior lumbar interbody fusion in
Mohsen Nabiuni1, Fatemeh Zarghami2
1Neurosurgery Department, School of Medicine, Iran University of Medical Science, Tehran, Iran. nabiuni.m@iums.ac.ir.
Background:
Bacterial meningitis is a rare but serious complication following neurosurgical procedures. Acinetobacter baumannii (A. baumannii) has emerged as an opportunistic pathogen, causing serious infections worldwide. The increasing prevalence of multidrug-resistant strains presents growing challenge in healthcare settings. The occurrence of multidrug-resistant A. baumannii meningitis after Posterior Lumbar Interbody Fusion (PLIF) surgery is exceptionally uncommon.
Case Presentation:
We report a 59-year-old osteoporotic female who developed A. baumannii meningitis resistant to our available antibiotics following PLIF for L5/S1 spondylolisthesis. Although a minor durotomy occurred during surgery due to sever adhesion in the inflamed tissue and no cerebrospinal fluid (CSF) leakage was observed postoperatively. The patient experienced fever and headache on first day after discharge which was managed with ondansetron, and then gradual loss of consciousness six days after discharge occurred, leading to her readmission. Despite administration of intravenous antibiotics and two courses of intrathecal antibiotic therapy via an External Ventricular Drain (EVD), her condition progressively deteriorated, and she ultimately succumbed to the infection.
Conclusion:
This case highlights the critical importance of maintaining dura integrity and adhering to strict operating room sterilization protocols. As resistant organisms become increasingly prevalent, healthcare providers must exercise heightened vigilance in the early recognition and management of infections following neurosurgical procedures.
Insights
Multidrug-resistant Acinetobacter baumannii meningitis is a rare but fatal complication after Posterior Lumbar Interbody Fusion (PLIF) surgery. This case underscores the need for vigilance in preventing and managing neurosurgical infections, especially with resistant bacteria.
Area of Science:
- Neurosurgery
- Infectious Diseases
- Critical Care Medicine
Background:
- Bacterial meningitis is a severe complication post-neurosurgery.
- Acinetobacter baumannii (A. baumannii) is an opportunistic pathogen causing global infections.
- Multidrug-resistant (MDR) strains pose a significant healthcare challenge.
Purpose of the Study:
- To report an exceptionally rare case of MDR A. baumannii meningitis following Posterior Lumbar Interbody Fusion (PLIF).
- To emphasize the critical factors contributing to post-neurosurgical infections.
Main Methods:
- Case report of a 59-year-old female patient.
- Detailed clinical course including surgery, symptoms, and treatment.
- Management involved intravenous and intrathecal antibiotics via External Ventricular Drain (EVD).
Main Results:
- The patient developed MDR A. baumannii meningitis despite no initial cerebrospinal fluid (CSF) leak.
- Treatment with available antibiotics and intrathecal therapy was unsuccessful.
- The patient ultimately succumbed to the infection.
Conclusions:
- Maintaining dura integrity during surgery is crucial.
- Strict operating room sterilization protocols are essential to prevent infections.
- Early recognition and management of post-neurosurgical infections are vital due to increasing antimicrobial resistance.