Abstract Details

Chronic meningitis is an uncommon complication of neurosurgery. Some of the most common organisms shown to cause acute meningitis after neurosurgical procedures have been Staphylococcus, Klebsiella, Pseudomonas, and Candida species. Literature regarding chronic meningitis in this population is absent.

25 patients were identified who met inclusion criteria for this period with an antecedent neurosurgical procedure. The age range of the patients was 20-84 years, with a mean of 54.3.  Most commonly CSF cultures were negative (24%), followed by Staphylococcus (20%), Pseudomonas (12%), and Candida (12%). Most common antecedent surgical procedures were craniotomy (48%), ventriculoperitoneal shunt placement/revision (20%), and extraventricular drain placed (16%). 30-day mortality was 12% (3/25).

Risk factors for post-surgical meningitis include increased age, craniotomy, and CSF leak. CSF leak and craniotomy were associated with the deaths in our series. In patients with a bacterial etiology, the majority (60%) were from gram-positive organisms, which correlates with current literature showing a greater predominance of gram-positive organisms in these infections. Organisms grown in our patients were similar to previous studies on acute meningitis. Nearly half of our patients had a craniotomy, suggesting this is a risk factor for chronic meningitis in addition to acute meningitis. Our data demonstrated a lower mortality (12%) in neurosurgical chronic meningitis than has been reported for acute neurosurgical meningitis (22%-36%).