[Bupivacaine induced aseptic meningitis].
BACKGROUND
Drug-induced aseptic meningitis (DIAM) is an uncommon adverse reaction secondary to the administration of numerous agents. It is diagnosed by exclusion, and its outcome is generally excellent with complete long term recovery. There are few reports of DIAM associated to intrathecal administration of bupivacaine in the literature.


METHODS
We present a 16 year-old male patient who received spinal anaesthesia with 10 mg of bupivacaine prior to orthopedic surgery. A few hours later he complained of headache followed by confusion and stupor. A TC scan of the brain was normal. Diagnostic lumbar puncture revealed cloudy cerebrospinal fluid (CSF) with increased polymorphonuclear, increased protein and decreased glucose concentrations. Immediate treatment with antibiotics and corticosteroids was instituted and the patient rapidly recovered without sequelae. Blood and CSF cultures were negative, antibiotics were suspended and corticosteroids tapered.


CONCLUSIONS
To the best of our knowledge, we report a case of bupivacaine induced aseptic meningitis.
Besocke
A G
AG
Serviciio de Neurología, Hospital Privado de Comunidad, Mar de Plata (Argentina). agbesocke@sna.org.ar
Santamarina
R
R
Romano
L Martín
LM
Femminini
R Alfredo
RA
D000293:Adolescent; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000009:adverse effects* / Q000493:pharmacokinetics; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002045:Bupivacaine / Q000009:adverse effects* / Q000493:pharmacokinetics; D002555:Cerebrospinal Fluid / Q000166:cytology; D003907:Dexamethasone / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D050723:Fractures, Bone / Q000601:surgery; D006801:Humans; D007964:Leukocytosis / Q000209:etiology; D008297:Male; D008582:Meningitis, Aseptic / Q000134:cerebrospinal fluid / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D008682:Metatarsal Bones / Q000293:injuries / Q000601:surgery; D009504:Neutrophils; D011183:Postoperative Complications / Q000139:chemically induced* / Q000175:diagnosis
D000779:Anesthetics, Local; D000900:Anti-Bacterial Agents; D003907:Dexamethasone; D002045:Bupivacaine