Related Experiment Video

Updated: Jul 21, 2026

Microvascular Decompression: Salient Surgical Principles and Technical Nuances
10:35

Microvascular Decompression: Salient Surgical Principles and Technical Nuances

Published on: July 5, 2011

46.4K

Cerebrovascular Complications Associated With Iatrogenic Fungal Meningitis Following Surgical Procedures in Mexico

Andrea Becerril-Gaitan1, Shivani Bindal1, Samantha L Parker1

  • 1Neurosurgery Department (A.B.-G., S.B., S.L.P., M.P.M., H.A.Z., H.A.C., P.R.C., S.B., A.D., L.F.T., R.J.B., R.B., C.-J.C.), UTHealth Houston, TX.

Stroke
|November 29, 2023
PubMed
Abstract

Insights

Fungal meningitis from contaminated epidural anesthesia caused severe cerebrovascular complications (CVC), including arterial dissections and hemorrhages, leading to patient death. Early recognition and treatment are crucial for this emerging threat.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Public Health

Background:

  • An ongoing fungal meningitis outbreak linked to contaminated epidural anesthesia in Mexico.
  • Fusarium solani identified as the causative agent.
  • Cerebrovascular complications (CVC) associated with this outbreak have not been previously reported.

Purpose of the Study:

  • To describe a unique pattern of CVC in patients with iatrogenic fungal meningitis.
  • To highlight the clinical presentation and outcomes of affected individuals.

Main Methods:

  • Retrospective case series.
  • Inclusion of patients diagnosed with fungal meningitis after contaminated epidural anesthesia.
  • Documentation of CVC development during hospitalization.

Main Results:

  • Three female patients (mean age 35) presented with CVC due to fungal meningitis.
  • Positive Fungitell β-D-glucan assay in cerebrospinal fluid in all cases.
  • Severe vertebrobasilar vasculopathy, arterial dissections, subarachnoid, and intraventricular hemorrhages observed, leading to fatal outcomes.

Conclusions:

  • The fungal meningitis outbreak necessitates urgent recognition and treatment.
  • A significant risk of vertebrobasilar circulation CVC exists in these patients.
  • Public health awareness and a robust response are essential to address this emerging threat.
Keywords:
basilar arterybrain deathfemalestrokesubarachnoid hemorrhage

More Related Videos

A Visual Description of the Dissection of the Cerebral Surface Vasculature and Associated Meninges and the Choroid Plexus from Rat Brain12:31

A Visual Description of the Dissection of the Cerebral Surface Vasculature and Associated Meninges and the Choroid Plexus from Rat Brain

Published on: November 14, 2012

48.5K
Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations14:58

Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations

Published on: October 20, 2017

9.7K

Related Concept Videos

Cryptococcal Meningitis01:27

Cryptococcal Meningitis

Cryptococcal meningitis is a life-threatening opportunistic infection predominantly associated with HIV/AIDS, accounting for over 100,000 deaths annually worldwide. However, it also affects individuals with other forms of immunosuppression, including those undergoing immunosuppressive therapy, organ transplant recipients, patients with innate immunodeficiencies, and individuals with hematological disorders. The infection is caused mainly by Cryptococcus neoformans and Cryptococcus gattii,...
Bacterial Meningitis I: Introduction01:22

Bacterial Meningitis I: Introduction

Bacterial meningitis is a severe, life-threatening inflammation of the meninges, particularly the pia mater and arachnoid mater, affecting the subarachnoid space, ventricles, and cerebrospinal fluid (CSF). If untreated, it can lead to significant neurological complications or death.Causative AgentsCommon pathogens vary with age and immune status. In adults, major organisms include Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae. Streptococcus agalactiae (group B...
Bacterial Meningitis II: Pathophysiology01:26

Bacterial Meningitis II: Pathophysiology

Bacterial meningitis typically begins when pathogens such as Neisseria meningitidis and Streptococcus pneumoniae colonize the nasopharynx and invade the bloodstream. This process is facilitated by bacterial virulence factors, such as polysaccharide capsules, which resist phagocytosis and complement-mediated killing. Less commonly, bacteria reach the central nervous system via contiguous spread from infections like otitis media or sinusitis, through congenital or acquired dural defects, or...
Brain Abscess l: Introduction01:26

Brain Abscess l: Introduction

A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial infections,...
Increased Intracranial Pressure ll: Pathophysiology01:29

Increased Intracranial Pressure ll: Pathophysiology

Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins with...
Cerebral Edema ll: Pathophysiology01:22

Cerebral Edema ll: Pathophysiology

Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...