Bacteremia, Spinal Anesthesia, and Development of Meningitis

Berman, Ronald; Eisele, John H.

doi:10.1097/00000542-197805000-00020

Cited by 43 publications

(9 citation statements)

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“…Extensive microbiological work-up of viridans streptococci isolated from CSF is not usually necessary, unless subacute endocarditis is suspected or the patient is immunocompromised, has had a trauma or a catheter [8][9][10][11][12][13]. Table 2 summarizes 32 cases of patients with culture proven iatrogenic meningitis caused by viridans streptococci reported in the English literature since 1950 [3,7,9,11,[14][15][16][17][18][19][20][21][22][23][24][25][26]. Reviewing reports from the communicable disease surveillance center of the public health service, between 1982 and 1992, we found 15 meningitis cases following either myelography or spinal anesthesia 0-able 3).…”

Section: Discussionmentioning

confidence: 99%

Alpha-hemolytic streptococci: A major pathogen of iatrogenic meningitis following lumbar puncture. Case reports and a review of the literature

1996

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Iatrogenic meningitis following lumbar puncture is a rare complication of myelography, spinal anesthesia, intrathecal chemotherapy, and epidural anesthesia. Sporadic cases and clusters of iatrogenic meningitis have been reported after intrathecal therapy, but most incidental cases are reported after myelography. Four cases of iatrogenic meningitis caused by viridans streptococci and a review of the literature are presented here. Observations and a case control study implicated a single anesthesiologist as the source. Probable cause of this cluster is non-observance of infection control measures as to the routine wearing of masks during the procedure. New infection control guidelines were implemented. A review of the literature on iatrogenic meningitis is given. Viridans streptococci have emerged as major pathogens of this complication. These findings underline the need to wear face masks since these bacteria are commensals of the oral cavity.

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Section: Discussionmentioning

confidence: 99%

Alpha-hemolytic streptococci: A major pathogen of iatrogenic meningitis following lumbar puncture. Case reports and a review of the literature

1996

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“…12 More recent reports often describe unusual or nosocomial organisms, and diagnosis is frequently confounded by the use of broad-spectrum antibiotics before the onset of clinical symptoms. [11][12][13] Nosocomial infections are suspected when an unusual pathogen such as Streptococcus salivarius, commonly found in the oral cavity, skin, and gastrointestinal tract, causes meningitis. Three recent reports describe a total of 5 patients undergoing minor orthopedic surgery who developed postspinal meningitis involving S salivarius.…”

Section: Meningitismentioning

confidence: 99%

Regional Anesthesia in the Febrile or Infected Patient

Wedel

Horlocker

2006

Regional Anesthesia and Pain Medicine

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“…Publiziert wurden lediglich wenige Fäl-le von bakterieller Meningitis nach SPA [8,12,28,50,75,87], wobei die von Corbett und Barrie berichteten wahrscheinlich durch kontaminiertes Material verursacht waren [8,28] …”

Section: Spinalanästhesieunclassified

“…Ein 60jähriger Patient entwickelte drei Tage nach operativer Entfernung von Nierensteinen in Allgemeinanäs-thesie Fieber und eine Leukozytose sowie eine anhaltende Hämaturie [12]. Als Begleiterkrankungen waren eine chronisch obstruktive Lungenerkrankung und ein chronischer Alkoholabusus bekannt.…”

Section: Introductionunclassified

Rückenmarknahe Regionalanästhesien bei Bakteriämie

1997

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Bacteraemia and septicaemia are generally thought to be relative or absolute contraindications for central neural axis (CNA) blocks. Postulated mechanisms for haematogenous infection of the central nervous system (CNS) caused by subarachnoid or epidural puncture might be an accidental vessel puncture, a change of pressure in the subarachnoid space, and the induction of a "locus minoris resistentiae." Infectious complications of diagnostic lumbar puncture, spinal or epidural anaesthesia are very rare. Although in animals meningitis can be induced by subarachnoid puncture during bactaeremia, there is no study that proves an increased risk for bacteraemic patients. Transient bacteraemia is common, especially in urological and obstetrical-gynecological procedures that are often done in regional anaesthesia, but the incidence of infectious complications is low. This review investigates the few published cases in which a haematogenous infection of the CNS may have been caused by regional anaesthesia. Based on current knowledge, bacteraemia cannot be an absolute, but only a relative contraindication for CNA blocks. Antibiotic chemoprophylaxis should be given before the puncture and the patients must be closely followed after the anaesthesia, particularly for the development of spinal epidural abscess. Because of the possibly increased risk of infectious complications, informed consent should be obtained from the patient.

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Bacteremia, Spinal Anesthesia, and Development of Meningitis

Cited by 43 publications

References 0 publications

Alpha-hemolytic streptococci: A major pathogen of iatrogenic meningitis following lumbar puncture. Case reports and a review of the literature

Alpha-hemolytic streptococci: A major pathogen of iatrogenic meningitis following lumbar puncture. Case reports and a review of the literature

Regional Anesthesia in the Febrile or Infected Patient

Rückenmarknahe Regionalanästhesien bei Bakteriämie

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