Epidural blood patch and acute varicella.
We present the case of a 38-yr-old woman who required an epidural blood patch in the context of acute varicella (chickenpox). The unique risks in this case include the possible triggering of central nervous system complications after the introduction of viremic blood into the epidural or intrathecal space. However, the risk was believed to be acceptable because the patient was receiving antiviral coverage. She enjoyed complete relief of her headache but experienced transient back and leg pain. Leptomeningeal irritation caused by acute varicella infection may put patients at increased risk for pain after epidural blood patch.
Martin
David P
DP
Department of Anesthesiology, Division of Pain Medicine, Mayo Clinic, Rochester, Minnesota.
Bergman
Bradley D
BD
Berger
Ines H
IH
D000208:Acute Disease; D000212:Acyclovir / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use; D017217:Blood Patch, Epidural; D002644:Chickenpox / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D005260:Female; D006261:Headache / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D010146:Pain / Q000209:etiology; D013116:Spinal Cord / Q000473:pathology; D000077483:Valacyclovir; D014633:Valine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use
D000998:Antiviral Agents; D014633:Valine; D000077483:Valacyclovir; D000212:Acyclovir