title: Epidural abscess following epidural analgesia in pediatric patients.
abstract: Epidural abscess following epidural analgesia is an unusual event especially in pediatric patients. Two patients presented with fever and local signs of infection without neurological deficit on day 4 after the initiation of epidural analgesia. Neuro-imaging studies revealed epidural abscess. Both pediatric patients were treated successfully with intravenous antibiotics. One of the patients' initial MRI was normal. However, the symptoms persisted and a followed-up scan revealed epidural abscess. The other patient presented with worsening local indurations over the epidural insertion site and positive blood culture with Hemolytic streptococcus. Our experience suggests that neuro-imaging study should be strongly considered to evaluate pediatric patients with suspicion of epidural abscess.
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115, USA. yuan-chi.lin@childrens.harvard.edu
authors.forename: Yuan-Chi
authors.initials: YC
authors.lastname: Lin
authors.forename: Christine
authors.initials: C
authors.lastname: Greco
mesh_terms: D015360:Analgesia, Epidural / Q000009:adverse effects*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002443:Ceftriaxone / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use; D002648:Child; D020802:Epidural Abscess / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D005260:Female; D018662:Fundoplication; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D012019:Reflex Sympathetic Dystrophy / Q000601:surgery; D013116:Spinal Cord / Q000473:pathology; D013290:Streptococcal Infections / Q000209:etiology / Q000382:microbiology / Q000473:pathology; D014640:Vancomycin / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D014640:Vancomycin; D002443:Ceftriaxone