Iatrogenic bacterial meningitis: an unmasked threat.
Iatrogenic bacterial meningitis (IBM) is a rare but serious complication of neuraxial procedures, such as spinal and epidural anesthesia or lumbar puncture. We report a case of a 46-year-old female who presented to the emergency department with bacterial meningitis after spinal anesthesia. We review the existing literature outlining the pathogenesis, vector hypothesis, diagnosis, treatment, and prevention as they relate to IBM. We highlight the role of the emergency physician in the rapid diagnosis of this disease, and underscore the need for sterile technique when performing lumbar punctures.
Department of Emergency Medicine, Madigan Army Medical Center, Tacoma, WA, USA. Robertbarnwell@gmail.com
Robert
R
Barnwell
Vincent
V
Ball
D000775:Anesthesia, Spinal / Q000009:adverse effects*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D016920:Meningitis, Bacterial / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D008875:Middle Aged; D013129:Spinal Puncture; D013290:Streptococcal Infections / Q000175:diagnosis* / Q000188:drug therapy; D034363:Viridans Streptococci / Q000302:isolation & purification
D000900:Anti-Bacterial Agents