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

Kim, Hyungsuk; Lim, So Young; Pyon, Jai Kyong; Mun, Goo Hyun; Bang, Sa Ik; Oh, Kap Sung

Case Report

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2011;38(4):516-518.
Published online July 1, 2011.

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

Hyungsuk Kim, So Young Lim, Jai Kyong Pyon, Goo Hyun Mun, Sa Ik Bang, Kap Sung Oh

Samsung Medical Center, Department of Plastic Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea. sy72.lim@samsung.com

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.

Keywords: Multidrug-resistant Streptococcus pneumoniae; Craniofacial surgery; Complications