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November 12, 1982

Pneumococcal Meningitis Associated With Retroperitoneal Abscess: A Rare Complication of Lumbar Puncture

JAMA. 1982;248(18):2308-2309. doi:10.1001/jama.1982.03330180068038

THE ASSOCIATION of bacterial meningitis with a retroperitoneal abscess is uncommon. There have been only four cases in the literature of meningitis caused by dissemination of a psoas abscess.1,2 Recently, we observed a patient with pneumococcal meningitis in whom a pneumococcal psoas abscess subsequently developed as an iatrogenic complication of a lumbar puncture.

Report of a Case  A 50-year-old man was admitted to the New York (Manhattan) Veterans Administration Medical Center for evaluation of fever, confusion, and lower back pain.The patient had been in good health until two weeks before admission, when he noted the onset of lower back pain without fever, abdominal pain, leg weakness, or incontinence of bowel or bladder. During the week before hospitalization, the patient visited two outpatient medical clinics for evaluation. He claimed that spinal roentgenograms were obtained and interpreted as normal. Bed rest and analgesics were prescribed both times. Two days before