cefotaxime and Cerebrospinal-Fluid-Rhinorrhea

A case of meningitis caused by Streptococcus Equisimilis and cerebrospinal fluid rhinorrhea, in which the head trauma occurred 16 years before, is presented. To the best of the author's knowledge this is the first case reported with such characteristics. Several precipitating factors could be responsible for the unusually late reopening of the fistula Streptococci equisimilis is an uncommon cause of the bacteremia. An appropriate antimicrobrial therapy against S. Equisimilis followed by surgical dural repair were performed.

Topics: Brain Injuries; Cefotaxime; Cerebrospinal Fluid Rhinorrhea; Drug Therapy, Combination; Frontal Lobe; Humans; Magnetic Resonance Imaging; Male; Meningitis, Bacterial; Middle Aged; Neurosurgical Procedures; Sphenoid Sinus; Streptococcal Infections; Streptococcus; Time Factors; Tomography, X-Ray Computed; Vancomycin

Bacterial meningitis secondary to CSF rhinorrhoea is well recognised. We present a case of meningitis due to Haemophilus influenzae type b associated with a CSF fistula. The patient was 40 years of age at presentation, having sustained a head injury when 3-years-old. He had suffered intermittent rhinorrhoea for 18 months before admission. Delays between head injury and meningitis are well recognised, but our case may represent the longest recorded interval. H. influenzae meningitis in adults is discussed.

Topics: Adult; Cefotaxime; Cerebrospinal Fluid Rhinorrhea; Craniocerebral Trauma; Humans; Male; Meningitis, Haemophilus; Time Factors

CT scanning was carried out in 508 patients with acute head injuries. Retrospective analysis of the findings revealed intracranial air in 49 cases (9.7%). Air may be situated in the extradural, subdural or subarachnoid spaces or intracerebrally. A pneumocephalus was detected in 40 out of 49 (82%) of head injury patients within 6 hours of the accident. Injuries associated with a pneumatocele or a single intracranial air bubble have a good prognosis, as do frontobasal lesions. Injuries associated with multiple air bubbles have a bad prognosis. Intracranial air was a sign of a frontobasal or laterobasal fracture. In cases with a depressed skull fracture, extracerebral haematoma or pneumocephalus acting as a space occupying lesion, an operation should be performed as soon as possible. If associated with a persistent rhinorrhea the CSF-fistula should be operated according to the generally accepted rules. In other post-traumatic cases intracranial air may be disregarded, although its presence may influence the choice of treatment.

Topics: Adolescent; Adult; Aged; Brain Injuries; Cefotaxime; Cerebrospinal Fluid Rhinorrhea; Child; Child, Preschool; Female; Gentamicins; Humans; Infant; Male; Middle Aged; Pneumocephalus; Premedication; Prognosis; Skull Fractures; Tomography, X-Ray Computed

Drip intravenous infusion of cefotiam (CTM) was made on patients who underwent cerebrospinal fluid (CSF) drainage and study was made on CSF transfer of CTM and at the same time on the relationship between CSF transfer of iodine contrast medium and CT scan findings. This study was made on 11 cases of cisternal drainage and 8 cases of ventricular drainage. Cisternal drainage cases were all postoperative cases of ruptured cerebral aneurysm. Cases of ventricular drainage included 4 postoperative cases of ruptured cerebral aneurysm, 1 case of CSF rhinorrhea, 2 cases of brain tumor, and 1 case of ventricular hemorrhage. Drip intravenous infusion of 1.0 g of CTM was made in one hour and at given periods thereafter CSF was collected and measured. CTM transferred to the CSF in cistern at a comparatively high concentration (16.3-0.7 microgram/ml). Hardly any transfer of CTM to the CSF in ventricle was seen in one case of cerebral aneurysm, CSF rhinorrhea, and brain tumor, but transfer was observed in one case of cerebral aneurysm, one case of brain tumor, and case of ventricular hemorrhage. Transfer of iodine contrast medium showed the positive correlation to the transfer of CTM. In cases of brain tumor and ventricular hemorrhage with transfer of CTM with ventricular drainage, enhancement effect of the ventricular wall by the contrast medium could be observed by CT scan. From the foregoing, the following results were obtained. There was good transfer of CTM to the CSF in cistern in postoperative cases of ruptured aneurysm. CTM did not transfer to CSF in the normal ventricle.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Brain Diseases; Brain Neoplasms; Cefotaxime; Cefotiam; Cerebral Hemorrhage; Cerebrospinal Fluid Rhinorrhea; Diatrizoate Meglumine; Drainage; Glioma; Humans; Infusions, Parenteral; Intracranial Aneurysm; Tomography, X-Ray Computed