title: Extensive abscess formation after repeated paravertebral injections for the treatment of chronic back pain.
abstract: Paravertebral injections are commonly used for the treatment of chronic back pain despite the lack of evidence for their efficacy. Here, we report a case in which repeated paravertebral injections of local anesthetics, corticosteroids and botulinum toxin resulted in extensive abscess formation involving the entire paravertebral musculature descending to the level of the midthighs. These abscesses induced a systemic inflammatory response syndrome and required surgical drainage as well as broad-spectrum antibiotic therapy.
authors.affiliation: Klinik für Anaesthesiologie und operative Intensivmedizin, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, D-12200 Berlin, Germany.
authors.forename: Wiebke
authors.initials: W
authors.lastname: Puehler
authors.forename: Alexander
authors.initials: A
authors.lastname: Brack
authors.forename: Andreas
authors.initials: A
authors.lastname: Kopf
mesh_terms: D018784:Abdominal Abscess / Q000209:etiology* / Q000473:pathology; D000208:Acute Disease; D000305:Adrenal Cortex Hormones / Q000009:adverse effects*; D000328:Adult; D001416:Back Pain / Q000188:drug therapy; D001905:Botulinum Toxins / Q000009:adverse effects*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007268:Injections, Epidural / Q000009:adverse effects*
chemical_list: D000305:Adrenal Cortex Hormones; D001905:Botulinum Toxins