Korean J Anesthesiol.  2009 Mar;56(3):337-340. 10.4097/kjae.2009.56.3.337.

Meningitis after a combined spinal epidural anesthesia: A case report

• Woo DH
• Kim SH
• Jang S
• Choi BM
• Koo MS
• Lee MA

• KMID: 2238135
• DOI: http://doi.org/10.4097/kjae.2009.56.3.337

Abstract

The incidence of post-dural puncture meningitis is very low. A 44-year-old patient developed a fever (38degrees C, headache, neck stiffness, nausea, and vomiting after combined spinal epidural (CSE) anesthesia and surgery for closed reduction and internal fixation (CRIF) with intramedullary (IM) nailing, tibia, Rt. With a preliminary diagnosis of bacterial meningitis, empiric broad spectrum antimicrobial treatment was immediately started after cerebrospinal fluid (CSF) sampling. The CSF was clear and revealed a white blood cell count, protein, glucose, and pressure of 146/micrometer, 225 mg/dl, 48 mg/dl (serum 151 mg/dl), and 26 cmH2O, respectively. The CSF stain and culture were negative. Considering the injection of preventive antibiotics before CSE anesthesia, partially treated bacterial meningitis was suspected. Four weeks later, clinical symptoms had improved before the patient was discharged.

Keyword

Cerebrospinal fluid; Combined spinal epidural anesthesia; Meningitis

MeSH Terms

Adult
Anesthesia
Anti-Bacterial Agents
Fever
Glucose
Headache
Humans
Incidence
Leukocyte Count
Meningitis
Meningitis, Bacterial
Nails
Nausea
Neck
Punctures
Tibia
Vomiting
Anti-Bacterial Agents
Glucose