[Meningitis after myelography]

Abstract

Lumbar myelography is still frequently used in cases of suspected lumbar radiculopathy. Since 1984, iohexol has been the contrast medium of choice in myelography, and so far only a few cases of chemical meningitis have been reported. Bacterial meningitis cannot be distinguished from chemical meningitis on the basis of clinical findings. A cerebrospinal fluid Gram stain and culture are the only truly reliable tests in deciding the etiology of the meningitis. We describe two patients who developed meningitis following myelography with iohexol. In one of the patients, the cerebrospinal fluid culture was positive with subsequent identification of Flavobacterium meningosepticum, a species not previously reported as an infectious agent in meningitis after myelography.