Catheter-related epidural abscesses -- don't wait for neurological deficits.
SourceActa Anaesthesiologica Scandinavica, 46, 5, (2002), pp. 611-615
Article / Letter to editor
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Acta Anaesthesiologica Scandinavica
SubjectThe role of cytokines in the pathophysiology of febrile illnesses and in host defense against infections; De rol van cytokinen in de pathofysiologie van koortsende ziekten en in de afweer tegen infecties
Epidural abscess is a rare but serious complication of epidural anesthesia for peri- and postoperative analgesia. It is feared because of possible persistent neurological deficits. Epidural abscess presents mostly with a classic triad of symptoms: back pain, fever and variable neurological signs and symptoms. When neurologic signs or symptoms develop, MRI scanning is the diagnostic procedure of choice. The therapy of choice is intravenous antibiotics for more than 4 weeks with or without a laminectomy or drainage. In the present paper we describe three patients with epidural abscesses presented during a time period of 1 year in our hospital. In each case, patients developed local signs of infection and systemic signs, but no neurological symptoms. Based on these cases and a review of the literature, we propose that MRI scanning should be strongly considered when patients present with systemic and local signs, even in the absence of neurological deficits.
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