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[2 cases of iatrogenic oral streptococcal infection: meningitis and spondylodiscitis]
S Molinier1, J F Paris, P Brisou
1Service de médecine interne, hôpital d'instruction des armées Sainte-Anne, Toulon Naval, France.
Introduction:
The multiplication of invasive spine investigations for either diagnostic or therapeutical purposes increases the risk for iatrogenic infections. We report two cases of iatrogenic infections, one case of meningitidis and one case of spondylodiscitis due to Streptococcus viridans.
Exegesis:
The two cases included a 42-year-old male patient presenting with spondylodiscitis due to Streptococcus oralis following nucleolysis for discal node and a 51-year-old female patient with purulent meningitidis due to Streptococcus salivarius following hysteroscopy with spinal anesthesia. According to the disease chronology and bacterial results, iatrogenesis was evidenced. The streptococci originate from the patient's skin or from the operators' endobuccal flora.
Conclusion:
Simple aseptic rules, including wearing a surgical mask during any spinal tap, would definitely avoid iatrogenic infections.
Insights
Iatrogenic infections from invasive spine procedures can be avoided. Simple aseptic techniques, like wearing a surgical mask during spinal taps, prevent serious infections such as meningitis and spondylodiscitis.
Area of Science:
- Infectious Diseases
- Neurosurgery
- Microbiology
Background:
- Invasive diagnostic and therapeutic spine procedures carry a risk of iatrogenic infections.
- Streptococcus viridans is a common pathogen implicated in these infections.
Observation:
- A 42-year-old male developed Streptococcus oralis spondylodiscitis after nucleolysis.
- A 51-year-old female contracted Streptococcus salivarius meningitis following hysteroscopy with spinal anesthesia.
Findings:
- Iatrogenic origin of infections was confirmed by disease timeline and bacterial analysis.
- The bacteria likely originated from the patient's skin flora or the healthcare provider's oral flora.
Implications:
- Adherence to basic aseptic protocols is crucial for preventing iatrogenic infections.
- Wearing surgical masks during spinal procedures can significantly reduce infection risk.