title: Streptococcus salivarius meningitis: a case report and literature review.
abstract: Twelve hours after spinal anaesthesia, a 61-year-old patient developed meningitis with fever, somnolence, headache and stiffness of the neck. The cerebrospinal fluid was found to contain 5.279/mm(3) cells (95 granulocytes), 12.800 mg/l protein and 14.0 mmol/l lactate. Streptococcus salivarius was detected in the culture. The patient was treated with antibiotics (initially cefotaxime, fosfomycin and gentamycin, later piperacillin and sulbactam). Restitutio ad integrum took place after 7 days. Thirteen cases of Streptococcus salivarius meningitis over the past 40 years are described in the literature, nine of which occurred following spinal puncture. Streptococcus salivarius was probably communicated by the medical personnel from the oral cavity when working without masks. The outcome in each case was good. In our opinion suitable masks must be worn during spinal puncture. Although iatrogenic infection is uncommon, it cannot be ruled out.
authors.affiliation: Department of Neurology, University of Leipzig, 04103 Leipzig Germany.
authors.forename: J
authors.initials: J
authors.lastname: Berrouschot
authors.forename: M
authors.initials: M
authors.lastname: Sterker
authors.forename: D
authors.initials: D
authors.lastname: Schneider