Meningitis--a complication of spinal anesthesia.

During a five-year period, 17 of 1429 patients admitted with meningitis had had recent spinal anesthesia in Cairo, Egypt. Ten of the 17 had positive cerebrospinal fluid cultures: 8 were Pseudomonas aeruginosa, 1 was Staphylococcus aureus, and 1 was Streptococcus mitis. These organisms were not cultured from patients who had not had spinal anesthesia. Two patients with negative cultures had lumbar spine x-ray changes consistent with tuberculosis. Antibiotic therapy was based upon the sensitivity of cultured organisms. Four of the 17 patients died. These data strongly suggest that meningitis in patients with recent spinal anesthesia is commonly due to unusual or nosocomial organisms. Aggressive, meticulous bacteriologic evaluation of these patients is essential.