Multilevel vertebral osteomyelitis and facet joint infection following epidural catheterisation.
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.
Arun
Ranganathan
R
Queen's Medical Centre, Nottingham, UK. arearoon@yahoo.com
Al-Nammari
Shafic Said
SS
Mehdian
S M Hossein
SM
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*
D000900:Anti-Bacterial Agents