title: Multilevel vertebral osteomyelitis and facet joint infection following epidural catheterisation.
abstract: We report a case of multilevel vertebral osteomyelitis with facet joint infection after epidural catheterisation. Back pain relating to regional anaesthetic techniques is common and usually self-limiting. However, it is essential to consider infection in any differential diagnosis. Prolonged use of these regional anaesthetics post-operatively makes the possibility of infection more likely. The microbiology of spine infection resulting from direct spread is not well documented but the few cases reported suggest a wide range of causative organisms. For this reason in cases of spinal infection resulting from epidural catheterisation every effort should be made to obtain a direct tissue sample for pathogen identification and one should not simply rely on blood cultures or nonspecific empirical antimicrobials. Delays in commencing appropriate antimicrobials may result in considerable morbidity.
authors.affiliation: Queen's Medical Centre, Nottingham, UK. arearoon@yahoo.com
authors.forename: Ranganathan
authors.initials: R
authors.lastname: Arun
authors.forename: Shafic Said
authors.initials: SS
authors.lastname: Al-Nammari
authors.forename: S M Hossein
authors.initials: SM
authors.lastname: Mehdian
mesh_terms: D000767:Anesthesia, Epidural / Q000009:adverse effects*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006801:Humans; D007268:Injections, Epidural / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*; D011183:Postoperative Complications; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D011859:Radiography; D013122:Spinal Diseases / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology*; D013131:Spine / Q000473:pathology; D013211:Staphylococcus aureus / Q000302:isolation & purification; D016896:Treatment Outcome; D021801:Zygapophyseal Joint / Q000473:pathology*
chemical_list: D000900:Anti-Bacterial Agents