Posttraumatic Bacterial Meningitis

This is the authors' abstract. We don't add key points for this paper.

A retrospective study on 16 adult patients was performed to characterize posttraumatic meningitis. Although eight patients developed meningitis within 2 weeks of injury, the delay was more than a year in four patients. All patients had either a demonstrable skull fracture or cerebrospinal fluid (CSF) rhinorrhea, or both. Six patients had recurrent meningitis. Diplococcus pneumoniae was the infecting agent in 83% of episodes. Only one patient died of meningitis. Surgical closure of the CSF fistula was accomplished in seven patients. Certain conclusions concerning management of posttraumatic meningitis appear reasonable. Penicillin in large doses should be administered unless organisms likely to be penicillin-resistant are seen on CSF smear. Meningitis patients with a history of head trauma should be evaluated for evidence of a CSF fistula. Surgical correction of the fistula seems to be indicated in patients with recurrent meningitis, late occurrence of meningitis, or persistent rhinorrhea.