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Fatal Pyogenic Meningitis Post Lumbar Laminectomy: A Rare and Lethal Neurosurgical Complication

Utkal Keshari Suna1, Sunita Das2, Manas Ranjan Sahu3

  • 1Department of Forensic Medicine and Toxicology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha.

The American Journal of Forensic Medicine and Pathology
|November 7, 2025
PubMed

Insights

A rare case of postoperative bacterial meningitis after lumbar laminectomy led to a fatal outcome. The infection involved Acinetobacter baumannii and Pseudomonas aeruginosa, highlighting challenges in diagnosing aggressive nosocomial infections.

Area of Science:

  • Neurosurgery
  • Infectious Diseases
  • Pathology

Background:

  • Postoperative meningitis is a rare but severe complication of neurosurgery.
  • Lumbar laminectomy for disc prolapse carries a risk of infection.
  • Nosocomial meningitis can be aggressive and difficult to diagnose early.

Purpose of the Study:

  • To report a fatal case of postoperative bacterial meningitis.
  • To identify the causative pathogens in a post-laminectomy meningitis case.
  • To emphasize the importance of vigilance for multidrug-resistant organisms.

Main Methods:

  • Case report of a 55-year-old male patient.
  • Description of clinical course and autopsy findings.
  • Microbiological analysis of cerebrospinal fluid and autopsy samples.

Main Results:

  • The patient developed bacterial meningitis post-lumbar laminectomy.
  • Autopsy revealed extensive purulent exudate in the subarachnoid space.
  • Acinetobacter baumannii complex and Pseudomonas aeruginosa were identified as causative agents.

Conclusions:

  • This case underscores the rapid and aggressive nature of nosocomial meningitis.
  • Early diagnosis of postoperative meningitis presents significant challenges.
  • Vigilance for atypical and multidrug-resistant pathogens is crucial in the postoperative neurosurgical setting.
Keywords:
acinetobacter baumannii complexcomplication forensic medicinefatalforensic pathologylumbar laminectomymeningitisnosocomial infectionpostoperative

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