Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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Multidrug-Resistant Streptococcus pneumoniae Sepsis and Meningitis after Craniofacial Surgery: Case Report

두개안면부 수술 후 발생한 다약제내성폐렴구균패혈증및뇌막염: 증례보고

  • Kim, Hyung-Suk (Samsung Medical Center, Department of Plastic Surgery, Sungkyunkwan University School of Medicine) ;
  • Lim, So-Young (Samsung Medical Center, Department of Plastic Surgery, Sungkyunkwan University School of Medicine) ;
  • Pyon, Jai-Kyong (Samsung Medical Center, Department of Plastic Surgery, Sungkyunkwan University School of Medicine) ;
  • Mun, Goo-Hyun (Samsung Medical Center, Department of Plastic Surgery, Sungkyunkwan University School of Medicine) ;
  • Bang, Sa-Ik (Samsung Medical Center, Department of Plastic Surgery, Sungkyunkwan University School of Medicine) ;
  • Oh, Kap-Sung (Samsung Medical Center, Department of Plastic Surgery, Sungkyunkwan University School of Medicine)
  • 김형석 (성균관대학교 의과대학 성형외과학교실) ;
  • 임소영 (성균관대학교 의과대학 성형외과학교실) ;
  • 변재경 (성균관대학교 의과대학 성형외과학교실) ;
  • 문구현 (성균관대학교 의과대학 성형외과학교실) ;
  • 방사익 (성균관대학교 의과대학 성형외과학교실) ;
  • 오갑성 (성균관대학교 의과대학 성형외과학교실)
  • Received : 2011.04.03
  • Accepted : 2011.05.23
  • Published : 2011.07.10
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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 treatment. 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

References

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