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[Acute Streptococcus salivarius meningitis after spinal anesthesia]
E Kaiser1, A Suppini, J P de Jaureguiberry
1Département d'anesthésie-réanimation, HIA Sainte-Anne, Toulon-Naval, France.
Abstract:
The case of a 50-year-old woman who experienced an acute Streptococcus salivarius meningitis after a spinal anaesthesia for hysteroscopy is reported. The contamination of the cerebrospinal fluid may occur from a puncture during a bacteriaemia. Contamination from the patient's skin and from the upper airway's flora of the operator seems to be a more plausible cause. Spinal anaesthesia is contra-indicated in the febrile patient. Asepsis is essential during spinal puncture, including wearing a surgical face mask.
Insights
A rare case of Streptococcus salivarius meningitis occurred after spinal anesthesia. Strict aseptic techniques, including mask use, are crucial during spinal procedures to prevent bacterial contamination.
Area of Science:
- Neuroscience
- Infectious Diseases
- Anesthesiology
Background:
- Spinal anesthesia is a common procedure for gynecological surgeries like hysteroscopy.
- Bacterial meningitis is a serious infection of the membranes surrounding the brain and spinal cord.
- Streptococcus salivarius is a common bacterium found in the human upper respiratory tract.
Observation:
- A 50-year-old woman developed acute Streptococcus salivarius meningitis following spinal anesthesia for a hysteroscopy.
- The source of cerebrospinal fluid contamination was investigated.
Findings:
- While bacteremia can introduce bacteria, contamination from the patient's skin or the operator's respiratory flora is a more likely cause of meningitis post-spinal anesthesia.
- The specific pathogen identified was Streptococcus salivarius.
Implications:
- This case highlights the critical importance of rigorous aseptic protocols during spinal puncture.
- Spinal anesthesia should be avoided in febrile patients due to increased infection risk.
- Mandatory use of surgical face masks by operators is essential to minimize airborne contamination during spinal procedures.