Another freediving risk: meningitis

[trux]

I have just found a new medical document about a possible risk of freediving:

Infectious Disease Article - Meningitis

Pollara G et al. – The authors present a rare case of meningitis caused by Citrobacter koseri in an immunocompetent adult who had recently been freediving. Middle ear pressure changes from this recreational activity, and the subsequent inflammatory response, are likely to have provided this environmental organism access to the central nervous system, and thus the ability to cause clinically significant infection.

Perhaps also the increased permeability of the blood-brain barrier during prolonged apnea as reported in the study about S100B release (http://forums.deeperblue.com/freediving-science/83773-can-apnea-cause-brain-damage.html) could have also contributed to the meningitis infection. That's just my speculation, though, and not any expert conclusion.

In any case, it does not mean you'll catch meningitis each time you go freediving. Otherwise we would be all dead since a long time

 

[Rik]

The original article mentions an ear infection as cause of the meningitis, with a direct route through the mastoid bone on both sides of the skull. The pathogen was probably introduced with water during equalization.

So, no blood-brain barrier involved. Neither is blood a normal transmission route in immunocompetent adults for this specific strain of bacteria. Nevertheless, based on this case-report, you might want to advice against using sea-water to fill air cavities in the skull.