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Related Experiment Videos

Fulminant postsurgical Bacillus cereus meningitis: case report.

E Berke, W F Collins, A von Graevenitz

    Journal of Neurosurgery
    |October 1, 1981
    PubMed
    Summary

    A rare case of Bacillus cereus meningitis occurred in a patient after pituitary surgery. This highlights the importance of not dismissing Bacillus species as contaminants, especially after neurosurgery.

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    Area of Science:

    • Neuroscience
    • Infectious Diseases
    • Microbiology

    Background:

    • Pituitary adenomas can present with visual disturbances and hormonal imbalances.
    • Surgical intervention, such as transsphenoidal removal, is a common treatment for pituitary adenomas.
    • Prophylactic antibiotics are standard practice to prevent surgical site infections.

    Observation:

    • A 25-year-old woman developed meningitis with cerebrospinal fluid (CSF) pleocytosis and Gram-positive rods post-pituitary surgery.
    • The patient presented with decreased consciousness, papilledema, and bitemporal hemianopsia.
    • The causative agent was identified as Bacillus cereus, despite oxacillin prophylaxis.

    Findings:

    • Bacillus cereus can cause severe meningitis, particularly following intracranial surgery.

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  • The isolated Bacillus species demonstrated resistance to standard prophylactic antibiotics like penicillin and cephalosporins.
  • CSF pleocytosis and the presence of Gram-positive rods are key indicators of bacterial meningitis.

    • Implications:

    • Bacillus species should be considered potential pathogens in post-neurosurgical meningitis.
    • Standard antibiotic prophylaxis may not be effective against Bacillus species causing meningitis.
    • Prompt identification and evaluation of Bacillus species in CSF are crucial, especially in neurosurgical patients.