Mortality from peripartum meningitis

A young primigravid parturient had an uneventful labour under epidural anal gesia and delivered a healthy male infant. She returned 48 hours later with fever, vomiting and severe headache, but was misdiagnosed as having endome tritis. Further signs of meningitis appeared six hours later, however she s uccumbed to the infection and died four weeks later despite intensive care and high-dose antibiotic management. Causes of meningitis in the peripartum period are discussed. The possibilit y of a causal association between the patient's epidural analgesia and her infection are considered and preventive measures discussed.