Paracervical abscesses as life-threatening complications of outpatient pain treatment. Report of three cases.
The authors present three cases of iatrogenic paracervical abscesses caused by infiltration therapy of pain medications used in conservative treatment in patients with chronic cervicobrachialgia. All three patients had received this therapy several times before presenting with clinical signs of a local infection. The diagnosis was made based on results of the clinical examination, laboratory tests, and magnetic resonance imaging. The organism isolated was Staphylococcus aureus in all cases. After immediate surgery and long-term antibiotic therapy, all patients had a good outcome. The authors conclude that infectious complications after invasive outpatient treatment often go undiagnosed, but as shown in these three cases can lead to acute and sometimes life-threatening complications. If the disease is diagnosed early, immediate surgical evacuation combined with antibiotic therapy results in recovery. For medicolegal reasons it should kept in mind that even a routine injection may lead to such complications.
Schütze
Michael
M
Department of Neurosurgery, University of Rostock, Germany. michael.schuetze@med.uni-rostock.de
Piek
Jürgen
J
D000038:Abscess / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D000553:Ambulatory Care / Q000379:methods*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002574:Cervical Vertebrae / Q000473:pathology*; D006801:Humans; D007267:Injections / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D013122:Spinal Diseases / Q000175:diagnosis* / Q000188:drug therapy; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy; D013211:Staphylococcus aureus / Q000187:drug effects
D000900:Anti-Bacterial Agents