Complication rare et grave de la rachianesthésie: la méningite bactérienne (à propos d’un cas et revue de la littérature)

La rachianesthesie (RA) est la premiere anesthesie locoregionale. Elle comporte des effets secondaires et des risques qu'il faut pouvoir eviter, prevenir ou traiter precocement. C'est le cas d'une patiente operee sous rachianesthesie qui a presente quelques jours apres l'interventionde cephalees intenses associees a des nausees et des vomissements evoluant dans un contexte de fievre. La ponction lombaire mettait en evidence un liquide trouble avec la presence de cocci gram + a l'examen direct, ce qui a permis de poser le diagnostic d'une meningite bacterienne et dont l'evolution a ete favorable apres antibiotherapie. Mots cles: Meningite bacterienne, rachianesthesie, nosocomiale, complication grave, asepsie English Title: Rare and severe complication of spinal anesthesia: bacterial meningitis (about a case and literature review) English Abstract Spinal anesthesia (SA) is the first locoregional anesthesia. It can cause side effects and carry risks that need to be avoided, prevented or treated early. We here report the case of a female patient operated under spinal anesthesia who had intense headache associated with nausea and vomiting evolving in the context of fever within a few days after surgery Lumbar puncture showed cloudy liquid revealing Gram + cocci on direct examination. This allowed the diagnosis of bacterial meningitis. Patient’s evolution was favorable after antibiotic therapy. Keywords: Bacterial meningitis, spinal anesthesia, nosocomial, serious complication, asepsis