NEJM: Aspergillus Meningitis in Sri Lanka --- A Post-Tsunami Effect?

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The New England Journal of Medicine

February 15, 2007

Aspergillus Meningitis in Sri Lanka --- A Post-Tsunami Effect?

To the Editor: An outbreak of meningitis from infection with Aspergillus

fumigatus after the administration of spinal anesthesia for cesarean section

occurred between July 2 and July 25, 2005, in Colombo, Sri Lanka. The patients

were five previously healthy women. Their median age was 27 years (range, 21 to

38) (Table 1). They had received spinal anesthesia from different surgical

teams in two maternity hospitals. The mean incubation period was 11.2 days.

Fever, headache, and nuchal rigidity were common presentations. Remittent fever

continued despite initial treatment with broad-spectrum intravenous

antibiotics. Papilledema, lateral rectus palsy, and cerebral infarction and

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