El Goubi Manal, Khaleq Khalid, Moussaoui Mohammed
Anesthesia and Critical Care, Hôpital Universitaire International Cheikh Khalifa Ibn Zaid, Casablanca, MAR.
Anesthesia and Critical Care, Université Hassan II de Casablanca, Casablanca, MAR.
Cureus. 2025 Aug 6;17(8):e89501. doi: 10.7759/cureus.89501. eCollection 2025 Aug.
Nosocomial meningitis following spinal anesthesia is a rare but potentially life-threatening complication that breaches the central nervous system's natural defense barriers. This report presents a case of meningitis post spinal anesthesia, emphasizing the diagnostic, management, and preventive strategies for iatrogenic bacterial meningitis. A 53-year-old patient with sickle cell disease developed febrile confusion 10 days after spinal anesthesia for hemorrhoidal surgery, presenting with meningeal signs and positive infectious markers. Cerebrospinal fluid analysis revealed purulent fluid with leukocytosis, prompting empirical antibiotic therapy. Multi-resistant was identified, necessitating tailored antibiotic treatment and resulting in clinical improvement. Iatrogenic meningitis, though rare, poses significant risks in various medical settings involving spinal procedures. , identified as the causative agent in this case, presents challenges due to its antibiotic resistance. Early diagnosis, appropriate antibiotic selection, and adherence to hygiene protocols are crucial in managing infections effectively. Preventive measures, including strict adherence to skin disinfection protocols during invasive procedures, play a vital role in reducing the risk of nosocomial infections and ensuring patient safety post spinal anesthesia.
脊髓麻醉后发生的医院获得性脑膜炎是一种罕见但可能危及生命的并发症，它突破了中枢神经系统的天然防御屏障。本报告介绍了一例脊髓麻醉后脑膜炎病例，重点阐述了医源性细菌性脑膜炎的诊断、管理及预防策略。一名53岁的镰状细胞病患者在痔切除手术脊髓麻醉10天后出现发热性意识模糊，伴有脑膜刺激征和感染指标阳性。脑脊液分析显示脓性液体伴白细胞增多，遂进行经验性抗生素治疗。鉴定出多重耐药菌，需要针对性的抗生素治疗并最终实现临床改善。医源性脑膜炎虽然罕见，但在涉及脊髓操作的各种医疗环境中都存在重大风险。本病例中鉴定出的病原体因其抗生素耐药性而带来挑战。早期诊断、恰当的抗生素选择以及遵守卫生规程对于有效管理感染至关重要。预防措施，包括在侵入性操作期间严格遵守皮肤消毒规程，在降低医院获得性感染风险和确保脊髓麻醉后患者安全方面发挥着至关重要的作用。
