2025, Vol. 7, Issue 2, Part B
Case report: Aseptic meningitis following anal sphincterotomy under spinal anesthesia
Author(s): Urnaib Showkat, Masood Ahmad, Hina Bashir and Israr ul Haq
Abstract: Background: Aseptic meningitis is a rare but potentially life-threatening complication of spinal anesthesia, most often associated with intrathecal administration of local anesthetics such as bupivacaine. The clinical presentation may closely resemble bacterial meningitis, presenting with headache, vomiting, and altered mental status, making early differentiation difficult. In severe cases, cerebral edema and anisocoria may occur, indicating raised intracranial pressure and necessitating urgent management.
Case Presentation: This case report presents a 25-year-old female who underwent anal sphincterotomy under spinal anesthesia using 0.5% bupivacaine (3 mL). Two hours post-procedure, she developed severe headache, nausea, vomiting, and agitation, followed by progressive neurological deterioration. Initial CT brain was normal, but repeat imaging revealed cerebral edema. The patient developed anisocoria requiring endotracheal intubation and intensive care management with mannitol, corticosteroids, and supportive therapy. Cerebrospinal fluid analysis showed elevated protein and white blood cell count with neutrophilic predominance, normal glucose, and sterile cultures, consistent with drug-induced aseptic meningitis. Gradual neurological recovery was achieved over five days, and the patient was discharged without sequelae.
DOI: 10.22271/27080056.2025.v7.i2b.158Pages: 102-107 | Views: 220 | Downloads: 109Download Full Article: Click Here
How to cite this article:
Urnaib Showkat, Masood Ahmad, Hina Bashir, Israr ul Haq.
Case report: Aseptic meningitis following anal sphincterotomy under spinal anesthesia. J Case Rep Sci Images 2025;7(2):102-107. DOI:
10.22271/27080056.2025.v7.i2b.158
