The management of neurosurgical patients with postoperative bacterial or aseptic meningitis or external ventricular drain-associated ventriculitis

Abstract

This article is dedicated to the management of neurosurgical patients who develop postoperative meningitis or external ventricular drain (EVD)-related ventriculitis. Postoperative meningitis is either bacterial or aseptic, the latter occurring more commonly. However, owing to difficulties associated with distinguishing between the two processes, all patients with the clinical and laboratory features of postoperative meningitis should receive empirical antibiotic therapy; if a cultured sample of CSF is sterile after incubation for 3 days, the antibiotics can be discontinued. Patients with confirmed bacterial meningitis should be treated with one of the organism-specific regimens provided. Also provided are recommendations for the management of patients with EVD-related ventriculitis and a strategy for preventing shunt infections in patients with EVDs who undergo implantation of CSF shunts.

• Postoperative Infections Neurosurgery Management