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Meningitis after trans-sphenoidal excision of pituitary tumours

  • W. R. Gransden (a1), M. Wickstead (a1) and Susannah J. Eykyn (a1)

Summary

Between 1974 and 1986, eleven of 114 patients undergoing trans-sphenoidal removal of pituitary tumours developed meningitis despite prophylaxis, usually with chloramphenicol. Nine patients had cerebrospinal fluid rhinorrhoea and one died. A variety of pathogens was isolated, including enterobacteria, and four of the eleven were resistant to the antibiotics given as prophylaxis. Enterobacterial meningitis was always associated with infection of the sphenoidal sinus involving the muscle graft or nasal pack (five cases), and removal of the muscle graft was necessary in three cases despite the use of appropriate antibiotics.

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Corresponding author

Dr. S. J. Eykyn, Department of Microbiology, St. Thomas's Hospital Medical School, London SE1 7EH.

References

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Angell-James, J. (1967) The Hypophysis. Journal of Laryngology and Otology, 81: 12831307.
Johanson, W. G., Pierce, A. K. and Sanford, J. P. (1969) Changing pharyngeal bacterial flora of hospitalized patients. Emergence of Gram-negative bacilli. New England Journal of Medicine, 281: 11371140.
Romanowski, B., Tyrrell, D. L. J., Weir, B. K. A. and Goldsand, G. (1981) Meaningitis complication transsphenodial hypophysectomy, Canadian Medical Association Journal, 124: 11721175.
Wells, F. C., Newsom, S. W. B. and Rowlands, C. (1983) Wound infection in cardiothoracic surgery. Lancet, i: 12091210.
Westmore, G. A. and Whittam, D. E. (1982) Cerebrospinal fluid rhinorrhoea and its management. British Journal of Surgery, 69: 489492.
Wilson, C. B. and Dempsey, L. C. (1978) Transsphenoidal removal of 250 pituitary adenomas. Journal of Neurosurgeyr, 48: 1322.

Meningitis after trans-sphenoidal excision of pituitary tumours

  • W. R. Gransden (a1), M. Wickstead (a1) and Susannah J. Eykyn (a1)

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