trimethoprim--sulfamethoxazole-drug-combination and Hematoma--Subdural--Acute

17-year-old man had been involved in a traffic accident. He underwent a bilateral craniotomy with artificial dura mater to remove bilateral acute subdural hematomas. Seven months later, a right cranioplasty was performed using frozen auto-bone, and he developed extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae meningitis and an epidural abscess. Since his general status was poor, we could not remove the foreign body (artificial dura mater). He was successfully treated with meropenem and chronic suppression with oral trimethoprim-sulfamethoxazole. By describing this case and the results of a review of the pertinent literature, we discuss the importance of ESBL-producing Klebsiella pneumoniae meningitis in posttraumatic/postoperative patients.

Topics: Adolescent; Anti-Bacterial Agents; beta-Lactamases; Craniotomy; Drug Therapy, Combination; Epidural Abscess; Hematoma, Subdural, Acute; Humans; Klebsiella Infections; Klebsiella pneumoniae; Male; Meningitis; Meropenem; Postoperative Period; Thienamycins; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination