PSEUDOMONAS AERUGINOSA MENINGITIS FOLLOWING SPINAL ANESTHESIA: REPORT OF TWO SUCCESSFULLY TREATED CASES

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Abstract
Meningitis due to P. aeruginosa is rare, having been found in one of 804 cases during the period 1939-1949. Primary infections with this organism usually follow mechanical penetration of the meninges. The mortality in such cases reported in the literature prior to 1947 was 55%. It is even higher (86%) in P. aeruginosa meningitis secondary to a focus elsewhere or part of a systicemia. Since the introduction of streptomycin, 10 cases have been treated with this drug, with 6 revoveries. Serious toxic reactions were observed in 4 of those surviving. Two cases of P. aeruginosa meningitis successfully treated with streptomycin are reported. Both infections followed spinal anesthesia. Attention is called to the danger of contamination of the spinal subarachnoid space with improperly prepd. equipment and solns. for lumbar puncture, spinal anesthesia and intrathecal therapy. Cold sterilization of spinal fluid needles in alcohol is condemned. Streptomycin is the most effective agent in the treatment of P. aeruginosa meningitis, but its effectiveness is limited by the toxicity of the drug, and the mortality remains high despite combined parenteral and intrathecal therapy.