Hostname: page-component-669899f699-rg895 Total loading time: 0 Render date: 2025-05-02T06:24:59.187Z Has data issue: false hasContentIssue false
  • English
  • Français

Iatrogenic bacterial meningitis: an unmasked threat

Published online by Cambridge University Press:  11 May 2015

Robert Barnwell  and
Vincent Ball
Robert Barnwell*
Affiliation:
Department of Emergency Medicine, Madigan Army Medical Center, Tacoma, WA
Vincent Ball
Affiliation:
Department of Emergency Medicine, Madigan Army Medical Center, Tacoma, WA
*
724 S. Grant Avenue, Tacoma, WA 98405; [email protected].

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Iatrogenic bacterial meningitis (IBM) is a rare but serious complication of neuraxial procedures, such as spinal and epidural anesthesia or lumbar puncture. We report a case of a 46-year-old female who presented to the emergency department with bacterial meningitis after spinal anesthesia. We reviewthe existing literature outlining the pathogenesis, vector hypothesis, diagnosis, treatment, and prevention as they relate to IBM. We highlight the role of the emergency physician in the rapid diagnosis of this disease, and underscore the need for sterile technique when performing lumbar punctures.

Keywords

anesthesiabacterial meningitisepiduraliatrogeniclumbar puncturespinal
Type
Case Report • Rapport de cas
Information
Canadian Journal of Emergency Medicine , Volume 14 , Issue 4 , July 2012 , pp. 263 - 266
Copyright
Copyright © Canadian Association of Emergency Physicians 2012

References

REFERENCES

1.Pandian, JD, Carada, C, Radhakrishan, VV, et al. Iatrogenic meningitis after lumbar puncture—a preventable health hazard. J Hosp Infect 2004;56:119–24, doi:10.1016/j.jhin.2003.09.023.Google Scholar
2.Yaniv, LG, Potasman, I. Iatrogenic meningitis: an increasing role of resistant viridans streptococci? Case report and review of the last 20 years. Scand J Infect Dis 2000;32:693–6, doi:10.1080/003655400459658.Google Scholar
3.Wong, C. Spinal and epidural anesthesia. 1st ed. New York: McGraw Hill; 2007.Google Scholar
4.Trautmann, M, Lepper, PM, Schmitz, FJ. Three cases of bacterial meningitis after spinal and epidural anesthesia. Eur J Clin Microbiol Infect Dis 2002;21:43–5, doi:10.1007/s10096-001-0643-7.Google Scholar
5.Moen, V, Dahlgren, N, Irestedt, L. Severe neurological complications after central neuraxial blockades in Sweden 1990–1999. Anesthesiology 2004;101:950–9, doi:10.1097/00000542-200410000-00021.Google Scholar
6.Baer, ET. Post-dural puncture bacterial meningitis. Anesthesiology 2006;105:381–93, doi:10.1097/00000542-200608000-00022.Google Scholar
7.Roush, S, Birkhead, G, Koo, D. Mandatory reporting of diseases and conditions by health care professionals and laboratories. JAMA 1999;282:164–170, doi:10.1001/jama.282.2.164.Google Scholar
8.Pittet, D, Li, N, Woolson, RF, et al. Microbiological factors influencing the outcome of nosocomial bloodstream infections: a 6-year validated, population-based model. Clin Infect Dis 1997;24:1068–78, doi:10.1086/513640.Google Scholar
9.Ruoff, KL. Miscellaneous catalase-negative, gram-positive cocci: emerging opportunists. J Clin Microbiol 2002;40:1129–33.Google Scholar
10.Ryan, KJ, Ray, CG. Sherris medical microbiology, an introduction to infectious diseases: viridans and non-hemolytic streptococci. New York, NY: McGraw-Hill Medical Publishing Division; 2004.Google Scholar
11.Veringa, E, van Belkum, A, Schellekens, H. Iatrogenic meningitis by Streptococcus salivarius following lumbar puncture. J Hosp Infect 1995;29:316–8, doi:10.1016/0195-6701(95)90283-X.Google Scholar
12.Bacterial meningitis after intrapartum spinal anesthesia—New York and Ohio, 2008–2009. MMWR Morb Mortal Wkly Rep 2010;59:65–9.Google Scholar
13.Tunkel, AR, Hartman, BJ, Kaplan, SL, et al. Practice guidelines for the management of bacterial meningitis. Clin Infect Dis 2004;39:1267–84, doi:10.1086/425368.CrossRefGoogle ScholarPubMed
14.Philips, BJ, Fergusson, S, Armstrong, P, et al. Surgical face masks are effective in reducing bacterial contamination caused by dispersal from the upper airway. Br J Anaesth 1992;69:407–8, doi:10.1093/bja/69.4.407.Google Scholar
15.Siegel, JD, Rhinehart, E, Jackson, M, Chiarello, L, and the Healthcare Infection Control Practices Advisory Committee. 2007 guideline for isolation precautions: preventing transmission of infectious agents in healthcare settings. Available at: http://www.cdc.gov/ncidod/dhqp/pdf/isolation2007.pdf (accessed November 10, 2010).Google Scholar
16.Couzigou, C, Vuong, TK, Botherel, AH, et al. Iatrogenic Streptococcus salivarius meningitis after spinal anaesthesia: need for strict application of standard precautions. J Hosp Infect 2003;53:313–4, doi:10.1053/jhin.2002.1366.Google Scholar
17.Halaby, T, Leyssius, A, Veneman, T. Fatal bacterial meningitis after spinal anaesthesia. Scand J Infect Dis 2007;39:280–3, doi:10.1080/00365540600951309.Google Scholar