PDF(Pubmed)
Abstract：
UNASSIGNED: Intracranial infection is a common complication caused by craniotomy. In particular, patients in Intensive Care Units (ICU) are prone to intracranial infection with multiple drug-resistant bacteria. Due to the lack of sensitive antibiotics for the treatment of multiple drug-resistant bacteria, there are few literatures focusing on the treatment of intracranial infection, and patients often fail to receive unified and standardized treatment. Consequently, patients with Carbapenem-resistant bacteria intracranial infection report poor prognosis and high mortality. It is very important to discuss how to treat patients with intracranial infection caused by multidrug resistant bacteria.
UNASSIGNED: We reported a case of intracranial infection of Carbapenem-resistant Klebsiella pneumoniae(CRKp) due to high flap tension, poor wound healing and CSF leakage caused by subcutaneous fluid accumulation after intracerebral hemorrhage craniotomy. Since the patient was exposed to intracranial infection resulted from subcutaneous fluid accumulation, we adopted the method of continuous drainage with subcutaneous tube. When subcutaneous effusion disappeared, the subcutaneous drainage tube was pull out, while patients exhibited high fever again, the waist big pool drainage catheter and continuous drainage were carried out. According to the result of Subcutaneous effusion and CSF culture indicated multiple drug resistant Klebsiella pneumoniae intracranial infection and drug susceptibility, The treatment of gentamicin intrathecal injection, intravenous use amikacin and oral Paediatric Compound Sulfamethoxazole Tablets was adopted, the condition of intracranial infection was eventually controlled, with the consciousness restored. This patient was characterized by intracranial infection with Carbapenem-resistant Klebsiella pneumoniae(CRKp).
UNASSIGNED: Subcutaneous effusion is a high-risk factor for poor wound healing and interventions are required to be conducted to promote healing as early as possible to contribute to decreasing the menace of CSF leakage. In this case, Continuous drainage and intrathecal injection of sensitive antibiotics serve as critical process to determine the best strategy for clinical treatment of intracranial infection.
UNASSIGNED: We reported a case of intracranial infection of Carbapenem-resistant Klebsiella pneumoniae(CRKp) due to high flap tension, poor wound healing and CSF leakage caused by subcutaneous fluid accumulation after intracerebral hemorrhage craniotomy. Since the patient was exposed to intracranial infection resulted from subcutaneous fluid accumulation, we adopted the method of continuous drainage with subcutaneous tube. When subcutaneous effusion disappeared, the subcutaneous drainage tube was pull out, while patients exhibited high fever again, the waist big pool drainage catheter and continuous drainage were carried out. According to the result of Subcutaneous effusion and CSF culture indicated multiple drug resistant Klebsiella pneumoniae intracranial infection and drug susceptibility, The treatment of gentamicin intrathecal injection, intravenous use amikacin and oral Paediatric Compound Sulfamethoxazole Tablets was adopted, the condition of intracranial infection was eventually controlled, with the consciousness restored. This patient was characterized by intracranial infection with Carbapenem-resistant Klebsiella pneumoniae(CRKp).
UNASSIGNED: Subcutaneous effusion is a high-risk factor for poor wound healing and interventions are required to be conducted to promote healing as early as possible to contribute to decreasing the menace of CSF leakage. In this case, Continuous drainage and intrathecal injection of sensitive antibiotics serve as critical process to determine the best strategy for clinical treatment of intracranial infection.
摘要：
未经证实：颅内感染是开颅手术引起的常见并发症。特别是,重症监护病房(ICU)患者易发生多重耐药菌颅内感染.由于缺乏治疗多重耐药菌的敏感抗生素,很少有文献关注颅内感染的治疗，患者往往得不到统一规范的治疗。因此,耐碳青霉烯类细菌颅内感染患者报告预后差,死亡率高.如何治疗多重耐药菌引起的颅内感染具有重要意义。
UnASSIGNED：我们报告了一例因高皮瓣张力而颅内感染耐碳青霉烯类肺炎克雷伯菌（CRKp）的病例，脑出血开颅手术后皮下积液引起的伤口愈合不良和脑脊液渗漏。由于患者暴露于皮下积液导致的颅内感染，我们采用皮下管持续引流的方法。当皮下积液消失时，皮下引流管拔出,当患者再次表现出高烧时，进行腰部大池引流导管和连续引流。根据皮下积液及脑脊液培养结果提示多重耐药肺炎克雷伯菌颅内感染及药敏,庆大霉素鞘内注射治疗,静脉注射阿米卡星和口服小儿复方磺胺甲恶唑片，颅内感染的情况最终得到了控制，意识恢复了。该患者的特征是颅内感染耐碳青霉烯类肺炎克雷伯菌（CRKp）。
未经证实：皮下积液是伤口愈合不良的高风险因素，需要进行干预以促进尽早愈合，以减少脑脊液渗漏的威胁。在这种情况下,持续引流和鞘内注射敏感抗生素是确定临床治疗颅内感染最佳策略的关键过程。
UnASSIGNED：我们报告了一例因高皮瓣张力而颅内感染耐碳青霉烯类肺炎克雷伯菌（CRKp）的病例，脑出血开颅手术后皮下积液引起的伤口愈合不良和脑脊液渗漏。由于患者暴露于皮下积液导致的颅内感染，我们采用皮下管持续引流的方法。当皮下积液消失时，皮下引流管拔出,当患者再次表现出高烧时，进行腰部大池引流导管和连续引流。根据皮下积液及脑脊液培养结果提示多重耐药肺炎克雷伯菌颅内感染及药敏,庆大霉素鞘内注射治疗,静脉注射阿米卡星和口服小儿复方磺胺甲恶唑片，颅内感染的情况最终得到了控制，意识恢复了。该患者的特征是颅内感染耐碳青霉烯类肺炎克雷伯菌（CRKp）。
未经证实：皮下积液是伤口愈合不良的高风险因素，需要进行干预以促进尽早愈合，以减少脑脊液渗漏的威胁。在这种情况下,持续引流和鞘内注射敏感抗生素是确定临床治疗颅内感染最佳策略的关键过程。
