Potential threat of meningitis from ampoule impurities: Prevention is always better than cure!

Muthiah, Thilaka; Mathews, Lailu; Sivashankar, K R

doi:10.4103/0019-5049.176280

Cited by 2 publications

(1 citation statement)

References 4 publications

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“…10 One point cut is widely practised to prevent inadvertent mixing of outside particles with the intrathecal drug. 11 It was done in our patient too.…”

Section: Discussionmentioning

confidence: 78%

Aseptic meningitis following spinal anaesthesia: An uncommon and challenging diagnosis

Dasgupta,

Chatterjee,

Chandra

2024

Journal of the Royal College of Physicians of Edinburgh

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Drug-induced aseptic meningitis (DIAM) or chemical meningitis following spinal anaesthesia has rarely been reported. DIAM is caused by meningeal inflammation due to intrathecally administered drugs or secondary to systemic immunological hypersensitivity. We hereby present a case of a young adult with aseptic meningitis following neuraxial anaesthesia possibly provoked by bupivacaine. The initial cerebrospinal fluid (CSF) picture revealed neutrophilic pleocytosis and normal glycorrhachia. CSF culture was negative. The patient was put on invasive mechanical ventilation and started on intravenous antibiotics. There was a rapid improvement in clinical condition without any residual neurological deficit within the next few days. Aseptic meningitis following neuraxial anaesthesia can be prevented by strict aseptic protocols and careful inspection of visible impurities while administering the intrathecal drug. Detailed history taking, clinical examination, and focused investigations can distinguish between bacterial and chemical meningitis. Appropriate diagnosis of this entity may guide the treatment regimen, reducing hospital stay and cost.

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“…10 One point cut is widely practised to prevent inadvertent mixing of outside particles with the intrathecal drug. 11 It was done in our patient too.…”

Section: Discussionmentioning

confidence: 78%