Epidural abscess following epidural analgesia in pediatric patients.
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.
Lin
Yuan-Chi
YC
Department of Anesthesiology, Perioperative and Pain Medicine, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115, USA. yuan-chi.lin@childrens.harvard.edu
Greco
Christine
C
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
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D014640:Vancomycin; D002443:Ceftriaxone