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This review article by van de Beek and colleagues discusses the risk factors for nosocomial meningitis and its prevention, identification, and treatment.
Meningitis can be a complication of craniotomy, internal and external ventricular catheters, external lumbar catheters, head trauma, and lumbar puncture. The greatest risk for meningitis is in patients with closed head trauma and a basilar skull fracture that results in leakage of cerebrospinal fluid (CSF), with reported infection rates as high as 25%. The site of a CSF leak is often difficult to identify. The article includes a computed tomography (CT) scan demonstrating a bony defect of the lamina cribrosa, which can cause a rent in the dura, leading to CSF leakage. The authors suggest th…