Publicação
Drug-Induced Aseptic Meningitis Following Spinal Anesthesia.
| Resumo: | Meningitis is a very uncommon complication of spinal anesthesia, and drug-induced aseptic meningitis (DIAM) is even rarer. We present two cases of DIAM following spinal anesthesia with bupivacaine and ropivacaine, respectively. The patients presented shortly after the procedure with typical meningitis symptoms. Since CSF (cerebrospinal fluid) analysis could not initially exclude bacterial meningitis, they were started on empirical antibiotics. CSF was subsequently found to be negative for viruses and bacteria in both cases, and antibiotics were promptly stopped. Both patients improved rapidly and without neurological sequelae. While it remains a diagnosis of exclusion, it is important to be aware of DIAM as recognition of the condition can lead to shorter admission times and avoid unnecessary use of antibiotics. LEARNING POINTS: A diagnosis of DIAM should be considered when a patient who recently underwent spinal anesthesia is admitted with symptoms and CSF compatible with meningitis.Clinical and laboratory findings (including CSF analysis) cannot distinguish between bacterial meningitis and DIAM.A negative CSF culture and rapid recovery confirm the diagnosis and stopping antibiotics at this point is effective. |
|---|---|
| Autores principais: | Oliveira, R |
| Outros Autores: | Teixeira, M; Cochito, S; Furtado, A; Grima, B; Alves, JD |
| Assunto: | Aseptic meningitis Spinal anesthesia Bupivacaine Ropivacaine |
| Ano: | 2019 |
| País: | Portugal |
| Tipo de documento: | artigo |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Hospital Prof. Dr. Fernando Fonseca E.P.E. |
| Idioma: | inglês |
| Origem: | Repositório do Hospital Prof. Doutor Fernando Fonseca |
| _version_ | 1868417262089666560 |
|---|---|
| author | Oliveira, R |
| author2 | Teixeira, M Cochito, S Furtado, A Grima, B Alves, JD |
| author2_role | author author author author author |
| author_facet | Oliveira, R Teixeira, M Cochito, S Furtado, A Grima, B Alves, JD |
| author_role | author |
| contributor_name_str_mv | Unidade Local de Saúde Amadora / Sintra |
| country_str | PT |
| creators_json_txt | [{\"Person.name\":\"Oliveira, R\"},{\"Person.name\":\"Teixeira, M\"},{\"Person.name\":\"Cochito, S\"},{\"Person.name\":\"Furtado, A\"},{\"Person.name\":\"Grima, B\"},{\"Person.name\":\"Alves, JD\"}] |
| datacite.contributors.contributor.contributorName.fl_str_mv | Unidade Local de Saúde Amadora / Sintra |
| datacite.creators.creator.creatorName.fl_str_mv | Oliveira, R Teixeira, M Cochito, S Furtado, A Grima, B Alves, JD |
| datacite.date.Accepted.fl_str_mv | 2019-01-01T00:00:00Z |
| datacite.date.available.fl_str_mv | 2020-07-09T15:02:35Z |
| datacite.date.embargoed.fl_str_mv | 2020-07-09T15:02:35Z |
| datacite.rights.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| datacite.subjects.subject.fl_str_mv | Aseptic meningitis Spinal anesthesia Bupivacaine Ropivacaine |
| datacite.titles.title.fl_str_mv | Drug-Induced Aseptic Meningitis Following Spinal Anesthesia. |
| dc.contributor.none.fl_str_mv | Unidade Local de Saúde Amadora / Sintra |
| dc.creator.none.fl_str_mv | Oliveira, R Teixeira, M Cochito, S Furtado, A Grima, B Alves, JD |
| dc.date.Accepted.fl_str_mv | 2019-01-01T00:00:00Z |
| dc.date.available.fl_str_mv | 2020-07-09T15:02:35Z |
| dc.date.embargoed.fl_str_mv | 2020-07-09T15:02:35Z |
| dc.format.none.fl_str_mv | application/pdf |
| dc.identifier.none.fl_str_mv | http://hdl.handle.net/10400.10/2476 |
| dc.language.none.fl_str_mv | eng |
| dc.publisher.none.fl_str_mv | SMC Media |
| dc.rights.none.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| dc.subject.none.fl_str_mv | Aseptic meningitis Spinal anesthesia Bupivacaine Ropivacaine |
| dc.title.fl_str_mv | Drug-Induced Aseptic Meningitis Following Spinal Anesthesia. |
| dc.type.none.fl_str_mv | http://purl.org/coar/resource_type/c_6501 |
| description | Meningitis is a very uncommon complication of spinal anesthesia, and drug-induced aseptic meningitis (DIAM) is even rarer. We present two cases of DIAM following spinal anesthesia with bupivacaine and ropivacaine, respectively. The patients presented shortly after the procedure with typical meningitis symptoms. Since CSF (cerebrospinal fluid) analysis could not initially exclude bacterial meningitis, they were started on empirical antibiotics. CSF was subsequently found to be negative for viruses and bacteria in both cases, and antibiotics were promptly stopped. Both patients improved rapidly and without neurological sequelae. While it remains a diagnosis of exclusion, it is important to be aware of DIAM as recognition of the condition can lead to shorter admission times and avoid unnecessary use of antibiotics. LEARNING POINTS: A diagnosis of DIAM should be considered when a patient who recently underwent spinal anesthesia is admitted with symptoms and CSF compatible with meningitis.Clinical and laboratory findings (including CSF analysis) cannot distinguish between bacterial meningitis and DIAM.A negative CSF culture and rapid recovery confirm the diagnosis and stopping antibiotics at this point is effective. |
| dirty | 0 |
| eu_rights_str_mv | openAccess |
| format | article |
| fulltext.url.fl_str_mv | https://repositorio.hff.min-saude.pt/bitstreams/6f037e14-1d11-4822-8374-9c68de4e46aa/download |
| id | rhff_726528e9bb2fb5b712a7ffd433cf3a33 |
| identifier.url.fl_str_mv | http://hdl.handle.net/10400.10/2476 |
| instacron_str | hff |
| institution | Hospital Prof. Dr. Fernando Fonseca E.P.E. |
| instname_str | Hospital Prof. Dr. Fernando Fonseca E.P.E. |
| language | eng |
| network_acronym_str | rhff |
| network_name_str | Repositório do Hospital Prof. Doutor Fernando Fonseca |
| oai_identifier_str | oai:repositorio.hff.min-saude.pt:10400.10/2476 |
| organization_str_mv | urn:organizationAcronym:hff |
| person_str_mv | Oliveira, R Teixeira, M Cochito, S Furtado, A Grima, B Alves, JD |
| publishDate | 2019 |
| publisher.none.fl_str_mv | SMC Media |
| reponame_str | Repositório do Hospital Prof. Doutor Fernando Fonseca |
| repository_id_str | urn:repositoryAcronym:rhff |
| service_str_mv | urn:repositoryAcronym:rhff |
| spelling | engSMC Mediapt_PTMeningitis is a very uncommon complication of spinal anesthesia, and drug-induced aseptic meningitis (DIAM) is even rarer. We present two cases of DIAM following spinal anesthesia with bupivacaine and ropivacaine, respectively. The patients presented shortly after the procedure with typical meningitis symptoms. Since CSF (cerebrospinal fluid) analysis could not initially exclude bacterial meningitis, they were started on empirical antibiotics. CSF was subsequently found to be negative for viruses and bacteria in both cases, and antibiotics were promptly stopped. Both patients improved rapidly and without neurological sequelae. While it remains a diagnosis of exclusion, it is important to be aware of DIAM as recognition of the condition can lead to shorter admission times and avoid unnecessary use of antibiotics. LEARNING POINTS: A diagnosis of DIAM should be considered when a patient who recently underwent spinal anesthesia is admitted with symptoms and CSF compatible with meningitis.Clinical and laboratory findings (including CSF analysis) cannot distinguish between bacterial meningitis and DIAM.A negative CSF culture and rapid recovery confirm the diagnosis and stopping antibiotics at this point is effective.application/pdfpt_PTDrug-Induced Aseptic Meningitis Following Spinal Anesthesia.Oliveira, RTeixeira, MCochito, SFurtado, AGrima, BAlves, JDHostingInstitutionOrganizationalUnidade Local de Saúde Amadora / Sintrae-mailmailto:repositorio@hff.min-saude.ptrepositorio@hff.min-saude.ptISSNIsPartOf2284-2594DOIIsPartOf10.12890/2019_001334.2020-07-09T15:02:35Z20192019-01-01T00:00:00ZHandlehttp://hdl.handle.net/10400.10/2476http://purl.org/coar/access_right/c_abf2open accessAseptic meningitisSpinal anesthesiaBupivacaineRopivacaine180639 bytesliteraturehttp://purl.org/coar/resource_type/c_6501journal articlehttp://purl.org/coar/access_right/c_abf2application/pdffulltexthttps://repositorio.hff.min-saude.pt/bitstreams/6f037e14-1d11-4822-8374-9c68de4e46aa/downloadEuropean Journal of Case Reports in Internal MedicineMilano |
| spellingShingle | Drug-Induced Aseptic Meningitis Following Spinal Anesthesia. Oliveira, R Aseptic meningitis Spinal anesthesia Bupivacaine Ropivacaine |
| status | SINGLETON |
| subject.fl_str_mv | Aseptic meningitis Spinal anesthesia Bupivacaine Ropivacaine |
| title | Drug-Induced Aseptic Meningitis Following Spinal Anesthesia. |
| title_full | Drug-Induced Aseptic Meningitis Following Spinal Anesthesia. |
| title_fullStr | Drug-Induced Aseptic Meningitis Following Spinal Anesthesia. |
| title_full_unstemmed | Drug-Induced Aseptic Meningitis Following Spinal Anesthesia. |
| title_short | Drug-Induced Aseptic Meningitis Following Spinal Anesthesia. |
| title_sort | Drug-Induced Aseptic Meningitis Following Spinal Anesthesia. |
| topic | Aseptic meningitis Spinal anesthesia Bupivacaine Ropivacaine |
| topic_facet | Aseptic meningitis Spinal anesthesia Bupivacaine Ropivacaine |
| url | http://hdl.handle.net/10400.10/2476 |
| visible | 1 |