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Case Reports
Spinal epidural abscess and meningitis following short-term epidural catheterisation for postoperative analgaesia.
- Juliaan R M van Rappard, Jip L Tolenaar, Anke B Smits, and Peter M N Y H Go.
- Department of Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands.
- BMJ Case Rep. 2015 Jan 1; 2015.
AbstractWe present a case of a patient with a spinal epidural abscess (SEA) and meningitis following short-term epidural catheterisation for postoperative pain relief after a laparoscopic sigmoid resection. On the fifth postoperative day, 2 days after removal of the epidural catheter, the patient developed high fever, leucocytosis and elevated C reactive protein. Blood cultures showed a methicillin-sensitive Staphylococcus aureus infection. A photon emission tomography scan revealed increased activity of the spinal canal, suggesting S. aureus meningitis. A gadolinium-enhanced MRI showed a SEA that was localised at the epidural catheter insertion site. Conservative management with intravenous flucloxacillin was initiated, as no neurological deficits were seen. At last follow-up, 8 weeks postoperatively, the patient showed complete recovery.2015 BMJ Publishing Group Ltd.
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