Streptococcus salivarius Meningitis Following Spinal Anesthesia

Infection as a complication of neuraxial blockade

“…pneumoniae or H. influenzae). 6 Among the 27 obstetric cases, 12 followed spinals, 14,[43][44][45]49,57,58 seven followed CSE analgesia, 51,53,54,56,60,61 two followed accidental dural puncture 46,48 (one the woman who had two blood patches) 46 and six followed apparently uncomplicated epidurals (see below). Dural puncture seems necessary to allow entry of the less pathogenic streptococci to the subarachnoid space.…”

“…While epidural abscess is primarily a complication of epidural catheter use, the route of infection via the catheter entry point and the causative organism the staphylococcus, nosocomial meningitis is a complication of dural puncture and is usually caused by streptococci of the viridans type, most commonly Strep salivarius. 13,14 This is not a skin organism, so where does it come from? The clue is in the name.…”

Pericardial placement of a pulmonary artery catheter

“…............................................................................................................................................................................................................................................... because it is not a bacterial pathogen that commonly causes meningitis. However, although Streptococcus salivarius is a commensal of the skin, the genitourinary tract, the gastrointestinal tract and the oral cavity, meningitis due to Streptococcus salivarius is mainly associated with spinal anaesthesia [7,8] or myelography [9][10][11].…”

Streptococcus Salivarius Acute Meningitis with Latent Petromastoiditis

“…These streptococci may be recovered from cerebrospinal fluid (CSF) cultures in meningitis consecutive to neurosurgical procedures or brain abscesses. To our knowledge, less than 30 cases of Streptococcus salivarius acute meningitis not linked to brain abscesses have been reported in the literature (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). We describe here a further case associated with latent subacute mastoiditis in a patient with a previous history of operated homolateral trigeminal neurinoma, and review the previously reported cases.…”

“…Most reported cases are incidental iatrogenic meningitis, related to medical invasive spine procedures for either diagnostic or therapeutic purposes (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). In these cases, streptococci come from the patient's skin or the operator's endobuccal flora in the absence of adequate aseptic precautions, or may occur as a result of spinal puncture in the event of bacteraemia.…”