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Vol. 68. Issue 6.
Pages 357-360 (June - July 2021)
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Vol. 68. Issue 6.
Pages 357-360 (June - July 2021)
Case report
DOI: 10.1016/j.redare.2020.06.018
Enterococcus faecium meningitis secondary to epidural anesthesia. About a case and review of the literature
Meningitis por Enterococcus faecium secundaria a anestesia epidural. A propósito de un caso y revisión de la literatura
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B. Ruiz Torresa,
Corresponding author
bruizt@gmail.com

Corresponding author.
, C. Ramos Paesab, T. Rivero Salvadorc, C. Marín Zaldivard, D. Gil Pérezb
a Servicio de Anestesiología y Reanimación, Hospital Clínico Universitario Lozano-Blesa de Zaragoza, Zaragoza, Spain
b Unidad de Enfermedades Infecciosas, Hospital Universitario Miguel Servet de Zaragoza, Zaragoza, Spain
c Servicio de Anestesiología y Reanimación, Hospital San Pedro de Logroño, La Rioja, Spain
d Hospital MAZ Zaragoza, Zaragoza, Spain
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Abstract

Septic meningitis secondary to epidural anesthesia is a rare but serious complication that is usually related to exogenous contamination from inadequate aseptic techniques, so the most frequent microorganisms observed are S. aureus and S. salivarius. We describe the case of a woman who, after receiving epidural anesthesia for normal delivery, presented septic meningitis due to E. faecium with recurrence after antibiotic treatment, probably secondary to pyogenic ventriculitis undetected in the first episode.

We highlight the rarity of the case, emphasizing the need for strict aseptic technique, and review the literature on the most appropriate treatment for this type of complication.

Keywords:
Epidural anesthesia
Meningitis
Enterococcus faecium
Resumen

La meningitis séptica secundaria a anestesia epidural es una complicación rara pero grave que suele estar relacionada con contaminación exógena a partir de técnicas de asepsia inadecuadas, por lo que los microorganismos más frecuentes observados son S. aureus y S. salivarius. Nosotros describimos el caso de una mujer que, tras la realización de anestesia epidural para un parto eutócico, presentó una meningitis séptica por E. faecium, que reicidivó posteriormente, probablemente debido a una ventriculitis piogénica que pasó inadvertida en el primer episodio. Destacamos la rareza del caso, hacemos hincapié en extremar la medidas de asepsia y revisamos la literatura sobre el tratamiento más adecuado en este tipo de complicaciones.

Palabras clave:
Anestesia epidural
Meningitis
Enterococcus faecium

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