Postoperative meningitis in patients with cervical cord tumor: a case report

Abstract

Postoperative meningitis after spinal surgery is a rare complication that can result in a life-threatening condition. Linezolid (LZD) is an oxazolidinone which has been approved in Japan for infections caused by methicillin-resistant Staphylococcus aureus. The authors encountered a case of postoperative meningitis with cerebrospinal fluid leakage (liquorrhoea) that occurred after resection of a cervical cord tumor. The infection was caused by methicillin-resistant Staphylococcus epidermidis(MRSE). Debridement and suture of the dura matter was carried out. LZD was given intravenously. The infection was cured without any sequelae. Based on this result, we concluded that LZD might be considered as one of the first choices for the treatment of postsurgical meningitis caused by MRSE.

Keywords: CSF leakage; Linezolid; Methicillin-resistant Staphylococcus epidermidis; Postoperative meningitis; Surgical site infection.

Fig. 1

Anteroposterior radiograph of the cervical spine. Enlargement of the left C3-4 foramen was observed (arrows).

Fig. 2

Preoperative magnetic resonance imaging of the cervical spine. The axial T2 image revealed a dumbbell type tumor compressing the spinal cord at the C3-4 levels (A). The gadolinium-enhanced frontal (B) and sagittal images (C) indicated that the tumor was markedly enhanced.

Fig. 3

Intraoperative findings of the tumor. The tumor was encapsulated by a thin membrane (arrows).

Fig. 4

Intraoperative findings at the second surgery. The defect of the dura matter was found and liquorrhoea through the defect was observed (arrow). The defect was tightly sutured.

Fig. 5

The pre- and postoperative clinical course at the time of the second surgery. The patient's condition was favorable after the second surgery. POP: Postoperation, CRP: C-reactive protein, SBT/ABPC: Sulbactam/ampicillin, FOM: Fosphomycin, LZD: Linezolid.