Epidural infection during continuous epidural blockade: a case report

概要

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We report an otherwise healthy patient who developed epidural infection during continuous epidural block. A man in his fifties with lumbar disc herniation received continuous epidural block for the treatment of pain in the low back and lower extremity. After disinfection of the skin with 0.5% chlorhexidine in 80% alcohol, an epidural catheter was easily inserted through L5/S1 intervertebral space. The site of epidural catheter insertion was disinfected with 0.5% chlorhexidine in 80% alcohol every morning. On the 12th day after epidural catheterization, fever and pain at the epidural puncture site developed. Headache, back pain, and pyrexia of 38.1°C developed next day. The epidural catheter was removed. Magnetic resonance imaging (MRI) suggested the presence of an epidural abscess at the L5 level. Headache and pyrexia improved after intravenous administration of antibiotic. Bacterial culture of the epidural catheter tip yielded Staphylococcus epidermidis. MRI performed one month later showed resolution of the epidural abscess. Physicians should pay a keen attention to the epidural infection even in otherwise healthy patients when an epidural catheter is inserted.
一般社団法人日本ペインクリニック学会の論文