Acute Obstructive Hydrocephalus Caused by <i>Pseudomonas</i><i>aeruginosa</i>Ventriculitis after Transsphenoidal Surgery: Case Report

作     者：Yasuhiko Hayashi Masayuki Iwato Daisuke Kita Katsuyoshi Miyashita 

作者机构：Department of Neurosurgery Graduate School of Medical Science Kanazawa University Kanazawa Japan 

出 版 物：《Open Journal of Modern Neurosurgery》 (现代神经外科学进展（英文）)

年 卷 期：2015年第5卷第1期

页      面：1-5页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Obstructive Hydrocephalus Ventriculitis Pseudomonas aeruginosa Transsphenoidal Surgery 

摘      要：Pseudomonas aeruginosa (P. aeruginosa) frequently causes various infections, some of which are serious and require prompt medical detection and appropriate antibiotic selection. Although P. aeruginosa commonly exists within the nasal cavity, meningitis or ventriculitis following transsphenoidal surgery to relieve P. aeruginosa has been reported only occasionally. However, as the endoscopic transnasal approach is more widely utilized for the suprasellar lesions, nosocomical P. aeruginosa infection associated with cerebrospinal fluid (CSF) leakage becomes more common in patients with panhypopituitarism who undergo transsphenoidal surgery. We report a case of a 36-year-old man with an intrasellar craniopharyngioma presenting with an acute obstructive hydrocephalus caused by P. aeruginosa ventriculitis following transsphenoidal surgery. Treatment with optimal antibiotics was initiated immediately after P. aeruginosa was recognized as the pathogen, and was continued for 3 months. After removal of the infected fascia and fat graft used for the closure of CSF leakage and sellar floor reconstruction, endoscopic third ventriculostomy was successfully performed to treat the obstructive hydrocephalus induced by the occlusion of the fourth ventricle outlet, resulting in a positive outcome. Although the obstructive hydrocephalus caused by P. aeruginosa is extremely rare, prompt detection and appropriate treatment should be required once P. aeruginosa ventriculitis happens.