[Iatrogenic and traumatic cerebro-meningeal infections]. / Infections cérébro-méningées iatrogéniques et traumatiques.

ABSTRACT

Nosocomial cerebro-meningeal infections have a severe prognosis and are increasing infrequence. Main causes are neurosurgical procedures, ventriculostomies, head trauma and rarely peridural anaesthesia and lumbar punctures. The diagnosis is usually difficult because of the poor specificity of the clinical and laboratory signs. Predominant pathogens are gram-negative bacteria (including Enterobacteriaceae and Pseudomonas) and staphylococci (including Staphylococcus epidermidis). Treatment is based on the use of 3rd generation cephalosporins and sometimes imipenem. An alternative choice is the use of 2nd generation quinolones. If staphylococci are suspected, vancomycin, alone or in combination is prescribed.