Pneumoencephalomeningitis secondary to infected lumbar arthrodesis with a fistula: a case report.

Published online: Jun 27 2001

Guerado, Peña,

Department of Orthopedic and Trauma Surgery, Hospital Costa del Sol, University of Malaga, 29600 Marbella, Malaga, Spain.


Pneumocephalus associated with spinal problems is very rare. Association with encephalomeningitis secondary to a fistula after an infected elective lumbar spine fusion has not been previously reported. The authors report a case in which the clinical onset of pneumoencephalomeningitis occurred after an airplane flight. CT-scan and lumbar puncture were used to make diagnosis; the treatment was based on parenteral antibiotics. The symptoms and signs of infection and neurological deficit resolved but the fistula remained. Diagnosis in such cases must be based upon CT-scan and lumbar puncture. Treatment should consist of systemic antibiotic therapy. Surgical management of infection and fistula is desirable, should the status of the patient allow such a treatment. In any case, as airplane flights in such cases may predispose to pneumocephalus, patients with an infected CSF fistula should avoid airplane flights until the problem is solved.