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[Epidural abscess following delivery with peridural analgesia. The question of prevention]
1Institut für Anästhesiologie, Klinikum Bamberg, Buger Strasse 80, 96049 Bamberg.
A 35-year-old healthy gravida 2 para 2 developed a spinal epidural abscess after uneventful obstetric epidural analgesia. The diagnosis was confirmed by gadolinium-enhanced MRI; immediate surgical drainage combined with long-term antibiotic treatment led to complete recovery. The symptoms and possible contributing factors (e.g. immunological impairment of the patient, duration of the catheterization, violation of hygienic standards, type of disinfectant and dressing) are discussed. Vigilance is essential to avoid complications in patients with epidural catheters, even after it has been removed, in order to introduce appropriate diagnostic and therapeutic measures without delay. Immediate treatment is decisive for long term prognosis which should be introduced before neurological dysfunction appears.
A 35-year-old healthy gravida 2 para 2 developed a spinal epidural abscess after uneventful obstetric epidural analgesia. The diagnosis was confirmed by gadolinium-enhanced MRI; immediate surgical drainage combined with long-term antibiotic treatment led to complete recovery. The symptoms and possible contributing factors (e.g. immunological impairment of the patient, duration of the catheterization, violation of hygienic standards, type of disinfectant and dressing) are discussed. Vigilance is essential to avoid complications in patients with epidural catheters, even after it has been removed, in order to introduce appropriate diagnostic and therapeutic measures without delay. Immediate treatment is decisive for long term prognosis which should be introduced before neurological dysfunction appears.