A case of lumbar epidural abscess caused by a single epidural block

概要

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There are few reports concerning epidural abscess following a single epidural block without catheter. In the case reported here, a single epidural block was considered to be involved in the etiology of lumbar epidural abscess and discitis. A 74-year-old man was diagnosed with lumbar spinal canal stenosis combined with radiculopathy and received a single epidural block once a week. After the 5th epidural block, he had progressive back pain and fever without neurologic deficits. MRI examination showed a subcutaneous and epidural mass behind the L4 vertebral body and L4/5 discitis. Antibiotic therapy was initiated immediately and emergency surgical decompression (laminectomy) was performed. Intraoperative findings showed discitis and liquid pus in the ventral epidural space. Culture of the pus and blood revealed staphylococcus epidermidis. He could walk independently without complication in 1 month after surgery. A single epidural block repeated through same route may cause epidural abscess.
一般社団法人日本ペインクリニック学会の論文