The Co-occurance of Meningitis and Para-spinal Infection after Repetitive Procedural Treatment of the Spine: A Case Report

ABSTRACT

STUDY DESIGN: Case report. OBJECTIVES: We report a case of meningitis combined with paraspinal infection in a patients who underwent numerous surgeries for and repetitive procedural treatment of the spine. SUMMARY OF LITERATURE REVIEW In patients with a history surgical and repetitive procedural treatment of the spine, one symptom of infection may be a fever with localized pain or tenderness along the spine. MATERIALS AND METHODS: A 69-year-old man was hospitalized due to pyrexia and myalgia. Eight years ago, he underwented spine surgery. After that, the patient underwent spinal intervention more than once per week in another hospital due to remaining pain. One week before his visit to the emergency room, myalgia and aggravation in the lower back arose. However, a paraspinal infection was not detected in a non-enhanced MRI. One day after admission, the patient showed signs of meningeal irritation signs and the the patient's mental state suddenly deteriorated. An emergency cerebrospinal fluid analysis showed typical findings of bacterial meningitis. An enhanced MRI of the brain showed pachymeningeal enhancement. An enhanced MRI of the spine showed a small abscess formation on the left paravertebral back muscle, and bilateral psoas muscle. RESULTS: Serrtia marcescens was identified on blood cultures obtained upon admission. Since antibiotics were used to treat Serratia marcescens, the fever subsided, and the patient's mental status returned to normal. CONCLUSIONS: For patients with a history of repetitive procedural treatments of the spine, a fever should be acknowledged as a symptom in meningitis or other infectious conditions.