Chemical meningitis, though rare, is a diagnosis of exclusion that must be considered in patients presenting with neurologic symptoms of undetermined cause. It is likely that any substance in contact with CSF can be the culprit.

We report a patient who underwent a routine dental procedure and developed subcutaneous emphysema (SCE) and pneumomediastinum (PM). Clinical management included oxygen therapy, pain control, rest and supportive therapy as needed. Our patient clinically improved with this treatment, and was discharged home two days later. It is important to be aware that even minimally invasive dental procedures can lead to SCE and PM.

Chemical meningitis is a rare, noninfectious complication of intrathecal manipulation. The common complaint of back pain may result in the need for neurosurgical procedures or placement of intrathecal pain pumps, which may give rise to this complication.