{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T16:19:38Z","timestamp":1755793178320,"version":"3.44.0"},"reference-count":0,"publisher":"SMW Supporting Association","issue":"4344","license":[{"start":{"date-parts":[[2012,10,21]],"date-time":"2012-10-21T00:00:00Z","timestamp":1350777600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Swiss Med Wkly"],"abstract":"<jats:p>Meningitis  due to Streptococcus pneumoniae is a  rare complication of trans-sphenoidal surgery. We present the case of a patient  who developed pneumococcal meningitis with associated bacteraemia after  elective endoscopic trans-sphenoidal resection of a pituitary macro-adenoma.  After initial treatment with ceftriaxone and dexamethasone, the patient made a  good recovery and dexamethasone was discontinued. Two days later the patient\u2019s  condition deteriorated rapidly, presenting focal and diffuse neurological  deficits. Cerebral MRI revealed widespread punctate ischaemic-type lesions  affecting both anterior and posterior vascular territories bilaterally and  involving features consistent with cerebral vasculitis. Antibiotic treatment  was broadened to include meropenem and dexamethasone was restarted, but the  patient remained in a comatose state and died 14 days later. Steroid treatment  may play a dual role in this poorly characterised infectious complication of  trans-sphenoidal pituitary surgery. This\u00a0possibility is discussed and the  options for prophylaxis are reviewed.<\/jats:p>","DOI":"10.4414\/smw.2012.13697","type":"journal-article","created":{"date-parts":[[2012,11,21]],"date-time":"2012-11-21T08:44:55Z","timestamp":1353487495000},"page":"w13697","source":"Crossref","is-referenced-by-count":2,"title":["Cerebral  vasculitis complicating postoperative meningitis: the role of steroids  revisited"],"prefix":"10.57187","volume":"142","author":[{"given":"Katharine E. A.","family":"Darling","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julien","family":"Niederhauser","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Bervini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Giulieri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roy T.","family":"Daniel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaques","family":"Bille","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veronique","family":"Erard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"36756","published-online":{"date-parts":[[2012,10,21]]},"container-title":["Swiss Medical Weekly"],"original-title":[],"link":[{"URL":"https:\/\/smw.ch\/index.php\/smw\/article\/download\/1606\/2096","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/smw.ch\/index.php\/smw\/article\/download\/1606\/2097","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/smw.ch\/index.php\/smw\/article\/download\/1606\/2096","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T04:12:46Z","timestamp":1755231166000},"score":1,"resource":{"primary":{"URL":"https:\/\/smw.ch\/index.php\/smw\/article\/view\/1606"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,10,21]]},"references-count":0,"journal-issue":{"issue":"4344","published-online":{"date-parts":[[2012,10,22]]}},"URL":"https:\/\/doi.org\/10.4414\/smw.2012.13697","relation":{},"ISSN":["1424-3997"],"issn-type":[{"type":"electronic","value":"1424-3997"}],"subject":[],"published":{"date-parts":[[2012,10,21]]}}}