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KMID : 0358820110380040516
Journal of Korean Society of Plastic and Reconstructive Surgeons
2011 Volume.38 No. 4 p.516 ~ p.518
Multidrug-Resistant Streptococcus pneumoniae Sepsis and Meningitis after Craniofacial Surgery: Case Report
Kim Hyung-Suk

Lim So-Young
Pyon Jai-Kyong
Mun Goo-Hyun
Bang Sa-Ik
Oh Kap-Sung
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.
KEYWORD
Multidrug-resistant Streptococcus pneumoniae, Craniofacial surgery, Complications
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