J Korean Soc Plast Reconstr Surg.  2011 Jul;38(4):516-518.

Multidrug-Resistant Streptococcus pneumoniae Sepsis and Meningitis after Craniofacial Surgery: Case Report

• Kim H
• Lim SY
• Pyon JK
• Mun GH
• Bang SI
• Oh KS

Abstract

PURPOSE
The prevalence of antibiotic-resistant Streptococcus pneumoniae meningitis has increased worldwide. There are some reports about postoperative antibiotic-resistant Streptococcus pneumoniae infection after craniofacial surgery, but, there is no report in Korea. We present a report on the treatment of postoperative multidrug-resistant Streptococcus pneumoniae (MRSP) meningitis and sepsis after craniofacial surgery based on our experience.
METHODS
The patient was a 7-year-old boy with Crouzon's disease who was treated by fronto-orbital bar advancement. Intraoperatively, frontal sinus opening was seen during osteotomy which was covered with forehead galeopericranial flap. MRSP meningitis was diagnosed after the surgery, he was treated with intravenous vancomycin, meropenem, and levofloxacin.
RESULTS
The patient was treated successfully after 3 weeks of intravenous antibiotics treatement. During the 8 month follow-up period, there was no neurologic sequelae.
CONCLUSION
Postoperative infection after craniofacial surgery is an important phenomenon that needs immediate recognition. Prevention, early diagnosis, and treatment immediate after onset are important as countermeasures against postoperative drug-resistant bacterial infection. To prevent adverse outcome and reoperation, proper antibiotics treatment should be performed.

Keyword

Multidrug-resistant Streptococcus pneumoniae; Craniofacial surgery; Complications

MeSH Terms

Anti-Bacterial Agents
Bacterial Infections
Child
Craniofacial Dysostosis
Early Diagnosis
Follow-Up Studies
Forehead
Frontal Sinus
Humans
Korea
Meningitis
Meningitis, Pneumococcal
Osteotomy
Pneumococcal Infections
Prevalence
Reoperation
Sepsis
Streptococcus
Streptococcus pneumoniae
Thienamycins
Vancomycin
Anti-Bacterial Agents
Thienamycins
Vancomycin