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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Are The Symptoms And Treatment For Meningitis?

On December 1st my wife had her third surgery in 14 months for a GBM. She was last on Avastin 12/29/2014. The stitches had been removed in mid December but the site opened yesterday 2/3/15 and CSF is coming out of her head. She had been in home hospice and we brought her into our local hospice facility. My wife does not want to go through another major surgery and the doctor here feels that he could stitch up the hole to keep the CSF from dripping and send her back home. I was worried that the open wound would cause her to contract meningitis. The doctor at hospice feels that is a low probability. Another surgeon at a major medical center thought that any leakage of CSF has a very high probability of allowing bacteria to enter and causing meningitis. Being in hospice we cannot get outside medical help. I know this is complicated, she has been put on 800/160 Bactrim 2x/d. What are your thoughts about meningitis and is bactrim enough?
Thu, 30 Apr 2015
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Infectious Diseases Specialist,  's  Response
Hello.

I fully understand the complexity of your situation. It is not easy to do right step without consent. But I agree that CSF leakage is majer risk factor for meningitis. The treatment of leakage hole should be utmost asepticly treated. And bactrim is fine like prevention, but it is not 100%!

I suggest you should try to speak with your wife to do surgical intervention to stop leakage.

Hope to find good wayout from this problem.
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What Are The Symptoms And Treatment For Meningitis?

Hello. I fully understand the complexity of your situation. It is not easy to do right step without consent. But I agree that CSF leakage is majer risk factor for meningitis. The treatment of leakage hole should be utmost asepticly treated. And bactrim is fine like prevention, but it is not 100%! I suggest you should try to speak with your wife to do surgical intervention to stop leakage. Hope to find good wayout from this problem.