[Epidural abscess following a lumbar epidural catheter for mobilization of the knee].
We report on a case of a lumbar epidural abscess with staphylococcus aureus following a catheter epidural anaesthesia in a previously healthy and not immunosuppressed 34-year-old female. The indication for the epidural anaesthesia was mobilization of the right knee following arthrotomy due to chronic synovitis. On postoperative day 7 the patient experienced lumbar pain, headache and meningism. Magnetic resonance imaging revealed an epidural abscess at the height of the 3rd and 4th lumbar vertebrae. A right-sided intralaminar fenestration with debridement and drainage of the abscess was carried out immediately after confirmation of the diagnosis. The patient was discharged from hospital on postoperative day 21 without any neurological sequelae. This is another addition to the published cases of epidural abscess following a epidural technique. It underlines the need for a proper aseptic technique, to abandon frequent changes of bacterial filters, daily examination of the entry site of the catheter and strategies for close and continuous monitoring of patients following epidural anaesthesia.
Kranke
W
W
Klinik für Anästhesiologie und Operative Intensivmedizin, Zentralklinikum Augsburg, Akademisches Lehrkrankenhaus, Ludwigs-Maximilians-Universität München.
Angster
R
R
Forst
H
H
D000038:Abscess / Q000209:etiology* / Q000382:microbiology / Q000473:pathology; D000328:Adult; D000767:Anesthesia, Epidural; D002908:Chronic Disease; D004824:Epidural Space; D005260:Female; D006801:Humans; D007717:Knee / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D011183:Postoperative Complications / Q000209:etiology* / Q000382:microbiology / Q000473:pathology; D013118:Spinal Cord Diseases / Q000209:etiology* / Q000382:microbiology / Q000473:pathology; D013203:Staphylococcal Infections / Q000209:etiology* / Q000382:microbiology / Q000473:pathology; D013585:Synovitis / Q000601:surgery