Clinical characteristics of post-neurosurgical Klebsiella pneumoniae meningitis in adults and a clinical comparison to the spontaneous form in a Taiwanese population

J Clin Neurosci. 2010 Mar;17(3):334-8. doi: 10.1016/j.jocn.2009.06.019. Epub 2010 Jan 25.

Abstract

A total of 46 patients (nine post-neurosurgical, 37 spontaneous) with adult bacterial meningitis (ABM) caused by Klebsiellapneumoniae infection were included in this study. The nine patients in the post-neurosurgical K. pneumoniae ABM group (seven male, two female) had a mean age of 48.9 years. Two patients in this group also had diabetes mellitus (DM) and one had liver disease. The most common presentation of patients in post-neurosurgical K. pneumoniae ABM group was fever (nine patients), followed by altered consciousness (seven patients) and hydrocephalus (six patients). With medical and/or surgical treatment, a mortality of 22.2% (2/9) occurred. Compared to patients who had spontaneous K. pneumoniae ABM, those with the post-neurosurgical form had a lower incidence of community-acquired infection, seizure and DM, but had a higher incidence of leukocytosis, hydrocephalus, cerebrospinal fluid leak and bacterial strains with extended-spectrum beta-lactamase. Univariate analysis found these clinical differences to be statistically significant, however they were not significant on multivariate analysis. This study reveals that there are clinical differences between the post-neurosurgical and spontaneous presentations of K. pneumoniae ABM.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Klebsiella Infections / cerebrospinal fluid
  • Klebsiella Infections / epidemiology
  • Klebsiella Infections / etiology*
  • Male
  • Meningitis, Bacterial / cerebrospinal fluid
  • Meningitis, Bacterial / epidemiology
  • Meningitis, Bacterial / etiology*
  • Middle Aged
  • Neurosurgical Procedures / adverse effects*
  • Postoperative Complications / microbiology*
  • Postoperative Complications / physiopathology*
  • Retrospective Studies
  • Taiwan / epidemiology
  • Young Adult