SynthesisInfection2017
Characteristics of meningitis following transsphenoidal endoscopic surgery: a case series and a systematic literature review.
Synthesis in Infection, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Burden of pneumococcal disease among adults in Southern Europe (Spain, Portugal, Italy, and Greece): a systematic review and meta-analysis.Human vaccines & immunotherapeutics · 2021Pooled it
- Postoperative CSF Characteristics After Extended Endoscopic Skull Base Surgery: Case Series and Review of the Literature.Journal of neurological surgery. Part B, Skull base · 2026Article
- Endoscopic Endonasal Approach for Craniopharyngiomas With Intraventricular Extension: Anatomic-Clinical Considerations and Surgical Outcomes in a Series of 61 Patients.Operative neurosurgery (Hagerstown, Md.) · 2026Article
- Dural repair after intraoperative CSF leakage in endoscopic endonasal skull base surgery without pedicled nasoseptal flap: is it a safe surgical technique?Neurosurgical review · 2025Article
- A study on the effectiveness of multiple intraoperative disinfections and bacteriological monitoring in reducing postoperative intracranial infection rates in transnasal endoscopic skull base surgery.Acta neurochirurgica · 2025Article
- Intracranial aspergilloma mimicking metachronous meningioma following transsphenoidal removal of a tuberculum sellae meningioma: illustrative case.Journal of neurosurgery. Case lessons · 2023Article
- Closure strategy for endoscopic pituitary surgery: Experience from 3015 patients.Frontiers in oncology · 2022Article
- Bacterial Flora in the Sphenoid Sinus Changes with Perioperative Prophylactic Antibiotic Administration.Neurologia medico-chirurgica · 2021Article
- Multidisciplinary management of acromegaly: A consensus.Reviews in endocrine & metabolic disorders · 2020Review
- Infectious Complications of Expanded Endoscopic Transsphenoidal Surgery: A Retrospective Cohort Analysis of 100 Cases.Journal of neurological surgery. Part B, Skull base · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMeningitis occurs in 0.8-1.5% of patients undergoing neurosurgery. The aim of the study was to evaluate the characteristics of meningitis after endoscopic endonasal transsphenoidal surgery (EETS) comparing the findings retrieved to those highlighted by literature search. MATERIALS AND
methodsPatients treated by EETS during an 18-year period in the Department of Neurosurgery of 'Federico II' University of Naples were evaluated and included in the study if they fulfilled criteria for meningitis. Epidemiological, demographic, laboratory, and microbiological findings were evaluated. A literature research according to PRISMA methodology completed the study.
resultsEETS was performed on 1450 patients, 8 of them (0.6%) had meningitis [median age 46 years (range 33-73)]. Endoscopic surgery was performed 1-15 days (median 4 days) before diagnosis. Meningeal signs were always present. CSF examination revealed elevated cells [median 501 cells/μL (range 30-5728)], high protein [median 445 mg/dL (range 230-1210)], and low glucose [median 10 mg/dL (range 1-39)]. CSF culture revealed Gram-negative bacteria in four cases (Klebsiella pneumoniae, Escherichia coli, Alcaligenes spp., and Haemophilus influenzae), Streptococcus pneumoniae in two cases, Aspergillus fumigatus in one case. An abscess occupying the surgical site was observed in two cases. Six cases reported a favorable outcome; two died. Incidence of meningitis approached to 2%, as assessed by the literature search.
conclusionsIncidence of meningitis after EETS is low despite endoscope goes through non-sterile structures; microorganisms retrieved are those present within sinus microenvironment. Meningitis must be suspected in patients with persistent fever and impaired conscience status after EETS.
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