Cerebrospinal fluid leak

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Background

  • CSF leaks are associated with a high risk of meningitis (10-25%, depending on etiology and chronicity)

Management

  • Current IDSA guidelines recommend:
    • No routine prophylactic antibiotic in patients with basilar skull fractures and CSF leak
    • Surgical repair if leak lasts more than 7 days
    • Pneumococcal vaccination

Further Reading

  • Clinical Practice Guidelines for Healthcare-Associated Ventriculitis and Meningitis. Clin Infect Dis. 2017;64(6):e34-e65. doi: 10.1093/cid/ciw861

References

  1. ^  Allan R. Tunkel, Rodrigo Hasbun, Adarsh Bhimraj, Karin Byers, Sheldon L. Kaplan, W. Michael Scheld, Diederik van de Beek, Thomas P. Bleck, Hugh J.L. Garton, Joseph R. Zunt. 2017 Infectious Diseases Society of America’s Clinical Practice Guidelines for Healthcare-Associated Ventriculitis and Meningitis*. Clinical Infectious Diseases. 2017;64(6):e34-e65. doi:10.1093/cid/ciw861.