ABSTRACT
Infection following brain cancer resection includes superficial wound infections, subgaleal fluid collection infection, meningitis, and brain abscess. The risk of SSI following neurosurgery in cancer patients is increased in patients with prior neurosurgery, chemotherapy, radiotherapy, prolonged use of corticosteroids, a history of prior wound infection, prolonged intraoperative time, and the placement of a gliadel (BCND) chemotherapy wafer into the brain tumor cavity. A cerebral spinal fluid (CSF) leak is a significant risk factor for meningitis. When a CSF leak is present, prophylactic antibiotics are warranted. The most common causes of superficial and deep-seated postneurosurgical infections are Staphylococcus aureus and enteric gram-negative bacilli (GNB), especially P. aeruginosa and Enterobacter species. Propionobacter acnes is a rare but life-threatening cause of brain abscess or meningitis following neurosurgery. If a foreign body is in place such as a bone plate or a ventriculoperitoneal shunt, then coagulase-negative Staphylococci are the most common cause of neurosurgical infections. Rarely, anaerobes such as anaerobic Streptococci and Peptostreptococcus can cause a deep-seated infection if the sinuses are entered during surgery.
