title: Iatrogenic meningitis in an obstetric patient after combined spinal-epidural analgesia: case report and review of the literature.
abstract: Iatrogenic meningitis is a rare but potentially fatal condition. We report a case of meningitis after combined spinal-epidural anesthesia and review previous reports of meningitis subsequent to spinal, combined spinal-epidural and epidural analgesia or anesthesia. Streptococci remain the most commonly identified agent, although cultures are frequently negative. Droplet contamination or needle contamination from incompletely sterilized skin are the major routes for infection. Strict aseptic technique and infection control measures should be employed when accessing the epidural space.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA.
authors.forename: Uriel
authors.initials: U
authors.lastname: Sandkovsky
authors.forename: Mircea Radu
authors.initials: MR
authors.lastname: Mihu
authors.forename: Adebisi
authors.initials: A
authors.lastname: Adeyeye
authors.forename: Pamela M
authors.initials: PM
authors.lastname: De Forest
authors.forename: Joshua D
authors.initials: JD
authors.lastname: Nosanchuk
mesh_terms: D000328:Adult; D015360:Analgesia, Epidural / Q000009:adverse effects*; D016362:Analgesia, Obstetrical; D003428:Cross Infection / Q000209:etiology* / Q000382:microbiology; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007049:Iatrogenic Disease; D017053:Infection Control / Q000592:standards*; D019300:Medical Errors / Q000009:adverse effects*; D016920:Meningitis, Bacterial / Q000209:etiology* / Q000382:microbiology; D011247:Pregnancy; D013290:Streptococcal Infections / Q000209:etiology*; D013291:Streptococcus / Q000302:isolation & purification