Bacterial Meningitis Following Spinal Anaesthesia for Caesarean Section

Abstract

We report a case of meningitis caused by inadvertent introduction of bacteria following spinal anaesthesia for Caesarean section. The technique of performing the spinal anaesthesia is reviewed. Meningitis may occur, although very rarely, despite meticulous aseptic techniques. It is vital that meningitis should be considered in the differential diagnoses of post-spinal headache when patients present with headaches, pyrexia and meningism in the postoperative or postpartum period.

Meningitis following a combined spinalepidural technique in a labouring term parturient

“…2 The CSF findings in our patient were nearly identical to those reported by Lee and Parry 2 who postulated that bacteria were introduced into the subarachnoid space during lumbar puncture despite a meticulous aseptic technique. 2 Bacterial meningitis has been reported to occur in pregnancy even without the previous use of spinal or epidural anaesthesia. The pathogens probably reach the CNS via the blood stream.…”

Outbreak of bacterial meningitis after spinal anaesthesia in Bangladesh

“…These were chemical theory, secondary meningitis theory and infective theory 8 . On the other hand, Lee JJ et al classified post spinal meningitis etiologically into bacterial, viral and aseptic or sterile 9 . Differentiation between bacterial and aseptic meningitis is difficult, but the later is characterized usually by a negative culture, normal CSF glucose concentration, high polymorphonuclear leukocytosis and elevated protein level.…”

Sepsis in obstetrics and the role of the anaesthetist

“…93 An incidence of 3% has been quoted in patients who had epidural catheters inserted for chronic pain procedures. 94 Similarly there are several case reports in the literature of meningitis following spinal and epidural anaesthesia and also epidural blood patches, [95][96][97] but it is difficult to draw firm conclusions from isolated reports. Common features to these reports include difficult procedures, multiple attempts and epidural catheters remaining in situ for extended periods.…”