Related Experiment Videos
Epidural blood patch and acute varicella.
David P Martin1, Bradley D Bergman, Ines H Berger
1Department of Anesthesiology, Division of Pain Medicine, Mayo Clinic, Rochester, Minnesota.
Anesthesia and Analgesia
|November 25, 2004
Summary
An epidural blood patch provided headache relief for a woman with chickenpox (acute varicella). However, this procedure may increase pain risk due to varicella-induced leptomeningeal irritation.
Area of Science:
- Neurology
- Infectious Diseases
- Anesthesiology
Background:
- Acute varicella (chickenpox) can cause leptomeningeal irritation, potentially leading to complications.
- Epidural blood patch (EBP) is a standard procedure for post-dural puncture headaches.
- The use of EBP in patients with active viremia presents unique risks.
Observation:
- A 38-year-old woman with acute varicella required an epidural blood patch for headache relief.
- The patient received antiviral medication, mitigating concerns about introducing viremic blood into the epidural space.
- She experienced complete headache resolution but developed transient back and leg pain post-procedure.
Findings:
- The epidural blood patch was effective in resolving the patient's headache.
- Transient back and leg pain occurred, possibly related to leptomeningeal irritation from the varicella infection.
- No central nervous system complications were observed, suggesting antiviral coverage may mitigate risks.
Implications:
- Leptomeningeal irritation from acute varicella may heighten the risk of post-epidural blood patch pain.
- Careful consideration of risks and benefits, including antiviral coverage, is crucial when performing EBP in viremic patients.
- This case highlights the importance of monitoring for neurological complications and pain after EBP in infectious conditions.