Nair Ajay, Lucarelli Vito, Hoyt Alastair
Department of Neurosurgery, College of Medicine and Life Sciences, University of Toledo, Toledo, United States.
Surg Neurol Int. 2024 Nov 15;15:424. doi: 10.25259/SNI_764_2024. eCollection 2024.
(AX) is an aerobic Gram-negative opportunistic bacteria known to inhabit various environments and is most commonly associated with nosocomial infections in immune-compromised patients. Although rare, AX can cause a variety of neurological infections, such as meningitis, ventriculitis, and osteomyelitis. Intravascular catheters, intrathecal pumps, and contaminated surgical instruments are potential vectors for such patients.
Here, we present a unique case of multidrug-resistant AX-positive meningitis secondary to infection of a nonfunctional intrathecal narcotic pump. The patient has a complex past medical history leading up to infection, and care was significantly compromised by homelessness and inflammatory bowel disease (IBD). Treatment included catheter removal and antibiotics.
Patients who suffer from homelessness or IBD show a possible increased risk of this infection. This case emphasizes the need for increased care regarding these patients, along with describing the complications and timeline when treating this rare type of meningitis.
(AX)是一种需氧革兰氏阴性机会致病菌,已知其存在于各种环境中,最常与免疫功能低下患者的医院感染相关。虽然罕见,但AX可引起多种神经系统感染,如脑膜炎、脑室炎和骨髓炎。血管内导管、鞘内泵和受污染的手术器械是此类患者的潜在传播媒介。
在此,我们报告一例独特的耐多药AX阳性脑膜炎病例,该病例继发于无功能鞘内麻醉泵感染。患者在感染前有复杂的病史,无家可归和炎症性肠病(IBD)严重影响了治疗。治疗包括拔除导管和使用抗生素。
无家可归或患有IBD的患者感染这种疾病的风险可能增加。本病例强调了对这些患者加强护理的必要性,同时描述了治疗这种罕见类型脑膜炎的并发症和病程。