Hansen Wilhelm, Dreyer Ingrid, Botes Lourens, Domah Karishma, Kashimbode Rose
Department of General Surgery, University of the Witwatersrand, Johannesburg, ZAF.
Department of Critical Care Medicine, Chris Hani Baragwanath Academic Hospital, Johannesburg, ZAF.
Cureus. 2024 Dec 23;16(12):e76235. doi: 10.7759/cureus.76235. eCollection 2024 Dec.
This report details the case of a 29-year-old male patient who presented at a tertiary-level trauma centre with multiple stab wounds to the face, chest, and back. Despite not undergoing surgical intervention or exhibiting any apparent cerebrospinal fluid (CSF) leakage during the initial evaluation. The patient's condition deteriorated, with subsequent cultures from CSF and blood confirmed extensively drug-resistant (XDR) Acinetobacter baumannii (A. baumannii) meningitis. Imaging revealed a spinal canal breach with abscess formation, necessitating targeted antibiotic therapy and neurosurgical debridement. This case highlights the potential challenges in diagnosing and managing A. baumannii meningitis, especially in trauma patients. Early recognition of risk factors, thorough clinical examination and multidisciplinary care were crucial for clinical improvement. The case also highlights the critical need for robust infection control measures to address the rising threat of XDR pathogens in healthcare settings.
本报告详细介绍了一名29岁男性患者的病例，该患者因面部、胸部和背部多处刺伤被送至三级创伤中心。尽管在初始评估期间未接受手术干预，也未出现任何明显的脑脊液（CSF）漏。但患者病情恶化，随后脑脊液和血液培养确诊为广泛耐药（XDR）鲍曼不动杆菌（A. baumannii）脑膜炎。影像学检查显示椎管破裂并形成脓肿，需要进行针对性抗生素治疗和神经外科清创术。该病例突出了诊断和管理鲍曼不动杆菌脑膜炎的潜在挑战，尤其是在创伤患者中。早期识别危险因素、全面的临床检查和多学科护理对临床改善至关重要。该病例还凸显了采取强有力的感染控制措施以应对医疗机构中XDR病原体日益增加的威胁的迫切需求。
