Neuraxial anesthesia (epidural and spinal) is a common regional anesthesia technique. Acute bacterial meningitis after spinal anesthesia is a rare event and rarely described enterococcal infection, usually occurring due to Enterococcus faecalis and Enterococcus faeciumm. We describe the first case in the Americas of meningitis caused by Enterococci casseliflavus in a young woman who received spinal anesthesia for osteosynthesis of the right ankle, who after three days developed headache, fever and disorientation. The cerebrospinal fluid (CSF) study and blood cultures confirmed the bacterial infection. The patient received antibiotic management with significant improvement. There are only two reported cases in the world of Central Nervous System involvement by Enterococci casseliflavus.
Bacterial meningitis
Meningitis por Enterococcus Casseliflavus Secundaria a Anestesia Raquídea: Primer Reporte de Caso en Las Américas. Enterococcus Casseliflavus Meningitis, Secondary To Spinal Anesthesia: First Case Report In The Americas
Accidente cerebrovascular en un paciente con meningitis por Streptococcus Constellatus. Stroke in a patient with Streptococcus Constellatus meningitis.
Streptococcus Constellatus ssp pharingi belongs to the group of Streptococcus Anginosus, it constitutes normal flora of th respiratory, gastrointestinal and genitourinary tracts, it infrequently produces localized or disseminated infections in patients with risk factors. The case of a 41-year-old male patient is reported, with a history of pituitary macroadenoma resection in 2003, undergoing treatment, who consulted the emergency department for 4 days with intense holocranial headache, fever, emesis, associated with temporospatial disorientation and weakness in lower limbs in the last 24 hours. He required management in the intensive care unit, mechanical ventilation, vasopressor support, and tracheostomy, due to respiratory and hemodynamic deterioration. In extension studies, meningitis due to Streptococcus Constellatus ssp pharingi was documented in the presence of sinusitis, cerebrospinal fluid fistula and multi-infarct cerebral vascular compromise, product of vasculitis of infectious origin, a severe manifestation of
bacterial meningitis, not previously reported by this microorganism.
