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  • Title: [Meningitis is a rare complication of spinal anesthesia. Good hygiene and face masks are simple preventive measures].
    Author: Moen V.
    Journal: Lakartidningen; 1998 Feb 11; 95(7):628, 631-2, 635. PubMed ID: 9495066.
    Abstract:
    Although bacterial meningitis is a rare sequela of spinal anaesthesia, occasional case reports continue to appear in anaesthesiological literature. The article presents nine cases of iatrogenic meningitis reported to the treatment injury claims authority. Eight of these patients had undergone spinal anaesthesia, and one myelography. Alpha-haemolytic streptococci were isolated in cerebrospinal fluid culture in seven cases, the remaining two cases being culture-negative. Although alpha-haemolytic streptococci are normal commensals of the upper respiratory tract and mouth and rarely cause spontaneous meningitis, they have been implicated in several reported cases of iatrogenic meningitis. The risk of such infection raises the issue of the widespread habit of omitting face masks when performing dural puncture. As these bacteria are not known to cause infection in general surgery, the necessity of using face masks in the operating theatre has been questioned. However, the use of face masks has been shown to reduce the risk of bacterial contamination from the upper airway; and as available documentation on iatrogenic meningitis suggests oral commensals to be responsible, the use of face masks should be mandatory whenever any kind of lumbar puncture is performed.
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