Pneumoencephalomeningitis secondary to infected lumbar arthrodesis with a fistula: a case report |
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Authors: | Guerado E Peña D |
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Affiliation: | Department of Orthopedic and Trauma Surgery, Hospital Costa del Sol, University of Malaga, 29600 Marbella, Malaga, Spain. eguerado@hcs.es |
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Abstract: | Pneumocephalus associated with spinal problems is very rare. Association with encephalomeningitis secondary to a fistula after an infected elective lumbar spine fusion has not been previously reported. The authors report a case in which the clinical onset of pneumoencephalomeningitis occurred after an airplane flight. CT-scan and lumbar puncture were used to make diagnosis; the treatment was based on parenteral antibiotics. The symptoms and signs of infection and neurological deficit resolved but the fistula remained. Diagnosis in such cases must be based upon CT-scan and lumbar puncture. Treatment should consist of systemic antibiotic therapy. Surgical management of infection and fistula is desirable, should the status of the patient allow such a treatment. In any case, as airplane flights in such cases may predispose to pneumocephalus, patients with an infected CSF fistula should avoid airplane flights until the problem is solved. |
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