Late Flavobacterium Species Meningitis After Craniofacial Exenteration

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Abstract
Flavobacteria are nonlactose-fermenting, Gram-negative bacilli that have been generally considered to be saprophytes. One species (meningosepticum) has been associated with neonatal meningitis but has been reported only rarely to cause disease in adults. This report presents a case of meningitis caused by a Flavobacterium species in a man nine months following craniofacial exenteration of the paranasal sinuses and describes the characteristics and possible sources of the organism. PATIENT SUMMARY A 43-year-old man was diagnosed as having a residual squamous cell carcinoma of the left paranasal sinus for which he was treated with 5,000 R irradiation six weeks before his referral to the National Cancer Institute. Following an extensive preoperative evaluation that was negative for metastases, the patient underwent craniofacial exenteration of the left paranasal sinuses. He received penicillin potassium and kanamycin sulfate prophylactically, before and after the operation. His postoperative course was uncomplicated with the exception of an episode of