Meningitis after obstetric spinal anaesthesia

Abstract

SummaryA case of meningitis after obstetric spinal anaesthesia is reported. The possible aetiological causes of postspinal meningitis are discussed and the dificulty in diferentiation between aseptic and bacterial meningitis noted. Ways to reduce the risk of bacterial contamination of cerebrospinaljuid are mentioned. The patient in this case made a full recovery, but the use of spinal anaesthesia in these patients is open to question.

Post spinal meningitis and asepsis

“…Dural puncture during bacteraemia may facilitate the entrance of bacteria into the CSF, but septic patients should only be submitted to regional anesthesia after a clinical response to antibiotics has been established (29). Endogenous sources of bacteria such as poor dental health (30), urinary tract infection (31), or manipulation of retained placenta (32) have been associated with meningitis. In the present study no patient had a preoperative diagnosis of an infectious disease.…”

Extradural Abscess Complicating Extradural Anaesthesia for Caesarean Section

“…Other infective complications of extradural anaesthesia in obstetrics have included non-abscess infection of the extradural space [24] and meningitis [25]. Meningitis has also been described after spinal anaesthesia in obstetrics [26,27].…”

Infection as a complication of neuraxial blockade

“…Nevertheless, judging by the numbers of published cases, it could be the second commonest neurological complication of neuraxial analgesia in labour, after paraesthesiae. Loo et al 6 found 20 cases, 31,[43][44][45][46][47][48][49][50][51][52][53][54] while at least seven others [55][56][57][58][59][60][61] and one case of Herpes simplex encephalitis 62 among parturients, and dozens more among non-obstetric patients, have been reported since.…”