MENINGITIS AFTER ADENOIDECTOMY - AN ANATOMIC EXPLANATION

Meningitisis is a rare complication of adenoidectomy. During a 5-month period, two children at St Christopher's Hospital for Children develo ped meningitis within days following this surgical procedure. The pote ntial causes of this complication that we investigated include coincid ence, systemic hematogenous spread of bacteria to the central nervous system, and direct or indirect contamination of the cerebrospinal flui d by bacteria introduced by retropharyngeal injection of lidocaine hyd rochloride and epinephrine. Based on statistical analysis of the avail able literature and anatomic studies of the pediatric nasopharyngeal r egion, we conclude that a retrograde flow of bacteria via a newly desc ribed anastomotic network of veins was the most likely cause of this s equela.