Bacterial meningitis following epidural anesthesia for vaginal delivery: a case report

Acute bacterial meningitis following epidural anesthesia is a rare event. We describe a case in which a young woman received epidural anesthesia for vaginal delivery. The initial attempt at placement of the epidural resulted in entry into the subarachnoid space. The patient's postpartum course was complicated by persistent headache. She received epidural blood patch on two occasions, but her headache continued and she developed persistent fever. The diagnosis of acute bacterial meningitis was made on postpartum day 3. Contamination of the subarachnoid space may have occurred at the time of the inadvertent spinal tap or via the epidural blood patch. Alternatively, this contamination may have occurred during a spontaneous bacteremic episode, as Streptococcus sanguis is a mouth organism commonly involved in dental caries.