Papadakis K A, Vartivarian S E, Vassilaki M E, Anaissie E J
Department of Medical Specialties, The University of Texas M.D. Anderson Cancer Center, Houston, USA.
J Neurosurg. 1997 Jul;87(1):106-8. doi: 10.3171/jns.1997.87.1.0106.
The authors report two cases of meningitis caused by Stenotrophomonas maltophilia in cancer patients following placement of an Ommaya reservoir for treatment of meningeal carcinomatosis. In addition, they review eight other cases of S. maltophilia that have been reported to date. Stenotrophomonas maltophilia meningitis is often associated with neurosurgical procedures; however, spontaneous infection may also occur, mainly in neonates. The disease's clinical presentation is similar to that of other forms of meningitis caused by Gram-negative bacilli. The overall mortality rate of this disease is 20% and is limited to neonates with spontaneous meningitis in whom effective antibiotic therapy is delayed. Meningitis caused by S. maltophilia in the modern era should be considered in immunocompromised hosts with significant central nervous system disease who have undergone neurosurgical procedures and who do not readily respond to broad-spectrum antimicrobial coverage.
作者报告了2例在植入Ommaya贮液器以治疗脑膜癌病后发生嗜麦芽窄食单胞菌性脑膜炎的癌症患者病例。此外，他们还回顾了迄今已报告的其他8例嗜麦芽窄食单胞菌病例。嗜麦芽窄食单胞菌性脑膜炎常与神经外科手术相关；然而，也可能发生自发性感染，主要发生在新生儿中。该疾病的临床表现与其他由革兰氏阴性杆菌引起的脑膜炎形式相似。这种疾病的总体死亡率为20%，且仅限于自发性脑膜炎且有效抗生素治疗延迟的新生儿。对于接受过神经外科手术且对广谱抗菌覆盖无明显反应的有严重中枢神经系统疾病的免疫功能低下宿主，应考虑现代时期由嗜麦芽窄食单胞菌引起的脑膜炎。
