Aseptic meningitis following spinal anaesthesia: An uncommon and challenging diagnosis.

IF 1.1 Q2 MEDICINE, GENERAL & INTERNAL
Sugata Dasgupta, Anurag Chatterjee, Atanu Chandra
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引用次数: 0

Abstract

Drug-induced aseptic meningitis (DIAM) or chemical meningitis following spinal anaesthesia has rarely been reported. DIAM is caused by meningeal inflammation due to intrathecally administered drugs or secondary to systemic immunological hypersensitivity. We hereby present a case of a young adult with aseptic meningitis following neuraxial anaesthesia possibly provoked by bupivacaine. The initial cerebrospinal fluid (CSF) picture revealed neutrophilic pleocytosis and normal glycorrhachia. CSF culture was negative. The patient was put on invasive mechanical ventilation and started on intravenous antibiotics. There was a rapid improvement in clinical condition without any residual neurological deficit within the next few days. Aseptic meningitis following neuraxial anaesthesia can be prevented by strict aseptic protocols and careful inspection of visible impurities while administering the intrathecal drug. Detailed history taking, clinical examination, and focused investigations can distinguish between bacterial and chemical meningitis. Appropriate diagnosis of this entity may guide the treatment regimen, reducing hospital stay and cost.

脊髓麻醉后的无菌性脑膜炎:不常见且具有挑战性的诊断。
脊髓麻醉后药物诱发的无菌性脑膜炎(DIAM)或化学性脑膜炎鲜有报道。药物诱发无菌性脑膜炎是由于鞘内给药引起的脑膜炎症或继发于全身性免疫超敏反应。我们在此介绍一例可能由布比卡因引发的神经轴麻醉后无菌性脑膜炎的年轻成人患者。最初的脑脊液(CSF)图像显示中性粒细胞增多,糖原正常。脑脊液培养呈阴性。患者接受了有创机械通气,并开始静脉注射抗生素。在接下来的几天里,患者的临床状况迅速好转,没有遗留任何神经功能缺损。神经轴麻醉后的无菌性脑膜炎可以通过严格的无菌操作规程和在鞘内给药时仔细检查可见杂质来预防。详细的病史采集、临床检查和重点检查可以区分细菌性脑膜炎和化学性脑膜炎。对这种疾病的适当诊断可以指导治疗方案,减少住院时间和费用。
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来源期刊
CiteScore
1.80
自引率
0.00%
发文量
81
审稿时长
20 weeks
期刊介绍: The Journal of the Royal College of Physicians of Edinburgh (JRCPE) is the College’s quarterly, peer-reviewed journal, with an international circulation of 8,000. It has three main emphases – clinical medicine, education and medical history. The online JRCPE provides full access to the contents of the print journal and has a number of additional features including advance online publication of recently accepted papers, an online archive, online-only papers, online symposia abstracts, and a series of topic-specific supplements, primarily based on the College’s consensus conferences.
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