[Infectious spondylodiskitis and epidural abscess after spinal puncture for pilonidal sinus excision].
Vertebral infections after spinal puncture are rare and often inadequately documented. Their incidence does not exceed that of spontaneous epidural abscesses and we should therefore be cautious about assuming a causal relation between puncture and an abscess. After analyzing 10 published cases we saw that only half of them reported on aseptic conditions and only 2 patients seem to have had a prior infection. In 3 cases, the abscesses appeared after technically simple punctures whereas half the reports did not even mention the type of puncture. This complication should be considered whenever a patient develops back pain and fever, even if there are no neurological deficits and even after a simple spinal puncture. Given that early diagnosis and treatment have proven effective in improving the survival rate and reducing the rate of neurological sequelae, magnetic resonance images should be ordered urgently so that early treatment can be established.
Pavón Benito
A
A
Servicio de Anestesiología y Reanimación, Hospital Virgen del Camino, Pamplona, Navarra. ruizpavon@yahoo.es
Asensio Martín
M J
MJ
de la Torre Campo
A
A
Esparza Murillo
I
I
Goldáraz Prados
C
C
Salvador Bravo
M
M
D000368:Aged; D000775:Anesthesia, Spinal; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000209:etiology; D001442:Bacteroides Infections / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D003131:Combined Modality Therapy; D003646:Debridement; D015299:Discitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D020802:Epidural Abscess / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery; D017809:Fatal Outcome; D005334:Fever / Q000209:etiology; D016964:Gram-Negative Anaerobic Cocci; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D006801:Humans; D015994:Incidence; D017116:Low Back Pain / Q000209:etiology; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging; D008297:Male; D010864:Pilonidal Sinus / Q000601:surgery*; D011677:Punctures / Q000009:adverse effects*; D012772:Shock, Septic / Q000209:etiology
D000900:Anti-Bacterial Agents