Document Detail


Salmonella enteritidis causing brain abscess and coxitis following intracranial surgery.
MedLine Citation:
PMID:  14577015     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We report the case of a 46-year-old woman who underwent surgery for an adamantinous craniopharyngeoma (WHO grade I). The postoperative course, during which the patient received 16 mg/day of dexamethasone, was initially uneventful. After a fortnight the patient developed infectious signs and an intracranial abscess at the operation site with simultaneous purulent coxitis. Both the intracranial abscess and the coxitis were evacuated and drained. In tissue samples and pus obtained during re-craniotomy and during surgery on the hip, Salmonella enteritidis was detected by cultivation. Salmonella enteritidis was also isolated from several stool specimens. There was no known salmonellosis in the patient's medical history. She recovered as a result of antibiotic treatment with ciprofloxacin and chloramphenicol. The intracranial abscess healed without leaving any neurological deficit. Unfortunately the left hip subsequently required further surgery, culminating in removal of the entire femoral head. Prosthetic replacement could not yet be performed due to the recurrent septic course of the hip. Our case illustrates a serious complication with presumed haematogenous spread of the infection from a pre-existing asymptomatic and unknown colon infection. The immunosuppressive effect of corticosteroids in the treatment of the brain neoplasm might have been a contributing factor to the sudden exacerbation of the latent infection.
Authors:
J Schröder; S Palkovic; F Kipp; H Wassmann
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Acta neurochirurgica     Volume:  145     ISSN:  0001-6268     ISO Abbreviation:  Acta Neurochir (Wien)     Publication Date:  2003 Oct 
Date Detail:
Created Date:  2003-10-24     Completed Date:  2004-03-30     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0151000     Medline TA:  Acta Neurochir (Wien)     Country:  Austria    
Other Details:
Languages:  eng     Pagination:  919-21; discussion 921     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, University of Münster, Münster, Germany. j.schroder@web.de
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MeSH Terms
Descriptor/Qualifier:
Adrenal Cortex Hormones / adverse effects,  therapeutic use
Bone Diseases, Infectious / etiology*,  pathology,  surgery
Brain Abscess / etiology*,  microbiology
Craniopharyngioma / surgery*
Female
Femur / microbiology,  pathology,  surgery
Hip / microbiology,  pathology,  surgery
Humans
Immunocompromised Host
Middle Aged
Pituitary Neoplasms / surgery*
Postoperative Complications*
Salmonella Infections / drug therapy,  etiology*,  pathology
Salmonella enteritidis / isolation & purification,  pathogenicity*
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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