title: Serratia marcescens meningitis following spinal anaesthesia and arthroscopy.
abstract: We present case of nosocomial bacterial meningitis, caused by Serratia marcescens (ESBL), occurred following spinal anaesthesia. Although very rare bacterial meningitis is serious complication of spinal anaesthesia and early diagnosis as well as effective treatment is extremely important. Previously healthy individual, admitted to Orthopaedic Department for routine arthroscopy, approximately within 24 hours after operation was performed complained of headache and fever. Infectious Diseases physician was consulted, lumbar puncture was performed and purulent meningitis was confirmed. Cerebrospinal fluid and blood cultures of patient confirmed Serratia marcescens (ESBL), resistant pathogen and important nosocomial agent. Patient was successfully treated. Cases of spinal meningitis caused by Serratia marcescens are rare. Local resistance pattern is important and should be always considered when starting therapy. Infection control team was appointed because of similar case of meningitis one month before in the same Department, and after investigation discovered Serratia in anaesthetic vial used in procedures. New measures and recommendations regarding infection control were implemented at Orthopaedic Department. Meningitis as a complication should always be considered as a possible differential diagnosis with patients after spinal anaesthesia complaining on headache and fever. Early diagnosis and early treatment is extremely important. Knowledge and practice of infection control measures is mandatory and should be always emphasized to performing staff.
authors.affiliation: Clinic for infectious Diseases, Clinical Center of University of Sarajevo, Bosnia and Herzegovina. hadzic.amir@gmail.com
authors.forename: Amir
authors.initials: A
authors.lastname: Hadzic
authors.forename: Nada
authors.initials: N
authors.lastname: Koluder-Cimic
authors.forename: Meliha
authors.initials: M
authors.lastname: Hadzovic-Cengic
authors.forename: Refet
authors.initials: R
authors.lastname: Gojak
authors.forename: Ismet
authors.initials: I
authors.lastname: Gavrankapetanovic
authors.forename: Semin
authors.initials: S
authors.lastname: Becirbegovic
mesh_terms: D000775:Anesthesia, Spinal / Q000009:adverse effects*; D001182:Arthroscopy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D016920:Meningitis, Bacterial / Q000209:etiology*; D016868:Serratia Infections / Q000209:etiology*; D012706:Serratia marcescens; D055815:Young Adult