Infections of the Central Nervous System Due to Pseudomonas Aeruginosa

Abstract

p SEUDOMONAS AERUGINOSA, formerly called B. pyocyanea, is one of the group of gram-negative organisms that have caused an increased percentage of hospital-acquired infections in recent years. 1,1~ Because pseudomonas rarely produces primary infections in man, 6 it has been referred to as an opportunist organism, a term suggesting a micro-organism that is part of the normal flora of man but that occasionally produces progressive infections in a host with impaired defenses. Pseudomonas infections may be relatively indolent, producing only slow host reactions, and therefore may persist for long periods before being diagnosed and properly treated. The characteristics noted above are particularly pertinent to pseudomonas infections of the central nervous system. Pseudomonas is the cause of about 5% of neonatal meningitis. 13,~4 In most instances pseudomonas meningitis has been superimposed on underlying disease, wound infection or eerebrospinal-fluid fistula; has extended from adjacent foci; or has been introduced by lumbar puncture, spinal anesthesia, or indwelling catheters draining cerebrospinal fluid. 2,3,~,~,12 In one large series, covering 10 years, pseudomonas was the causative organism in four out of 294 cases of bacterial meningitis (1.4%).5 An extensive review of reports of pseudomonas meningitis through 1955 is found in Forkner's monograph. 4 We are reporting 16 cases of pseudomonas infections of the central nervous system seen at the University of California Hospitals, and Fort Miley Veterans Administration Hospital, San Francisco, in the past 18 years. Two of the cases included in this series were described in detail previously. 7,s