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[Meningitis after myelography]

S H Bø1, K Nestvold, O Sortland

  • 1Nevrologisk avdeling, Sentralsykehuset i Akershus, Nordbyhagen.

Tidsskrift for Den Norske Laegeforening : Tidsskrift for Praktisk Medicin, Ny Raekke
|September 10, 1995
PubMed
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Two patients developed meningitis after lumbar myelography using iohexol contrast. One case involved Flavobacterium meningosepticum, a novel bacterial cause of meningitis following this diagnostic procedure.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Radiology

Background:

  • Lumbar myelography is a common diagnostic tool for suspected lumbar radiculopathy.
  • Iohexol has been the preferred contrast medium for myelography since 1984, with rare reports of chemical meningitis.
  • Distinguishing bacterial from chemical meningitis solely on clinical presentation is challenging.

Observation:

  • Two patients presented with meningitis symptoms subsequent to undergoing lumbar myelography with iohexol.
  • Cerebrospinal fluid analysis was crucial for determining the cause of meningitis.

Findings:

  • One patient's cerebrospinal fluid culture yielded Flavobacterium meningosepticum.
  • This marks the first reported instance of Flavobacterium meningosepticum causing meningitis after myelography.

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Implications:

  • Highlights the potential for bacterial meningitis following iohexol myelography.
  • Emphasizes the critical role of cerebrospinal fluid Gram stain and culture for accurate diagnosis.
  • Suggests the need for vigilance regarding rare bacterial pathogens in post-myelography meningitis.