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Development of Retroperitoneal Abscess Following Routine Injection of Triamcinolone for Musculoskeletal Pain
Sierra Sullivan1, Blayne Fenner1, Hannah McCool1
1Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA.
Abstract:
Glucocorticoid intramuscular injections are a quick, routine procedure done in an outpatient setting to relieve musculoskeletal pain quickly. However, despite being a low-risk procedure it can lead to local infections, including abscess and skin necrosis, and even more rarely, bacteraemia and multi-organ failure. In this case, we present a healthy, immunocompetent woman in her 40s diagnosed with a retroperitoneal abscess due to methicillin-resistant Staphylococcus aureus after an intramuscular injection of triamcinolone.
Learning Points:
Injections of glucocorticoids are commonly used in medical practice to alleviate musculoskeletal pain in addition to oral non-steroidal anti-inflammatory agents.Complications of injections include abscess formation, skin necrosis and sepsis, typically from Staphylococcus aureus or other skin colonisers.It should be understood that there are risks associated with injections regardless of age or co-morbidities, so these risks should be discussed with the patient in depth before administration.
Insights
Glucocorticoid injections for musculoskeletal pain, though common, carry risks. A healthy woman developed a serious retroperitoneal abscess from methicillin-resistant Staphylococcus aureus following a routine triamcinolone injection.
Area of Science:
- Infectious Diseases
- Pharmacology
- Musculoskeletal Medicine
Background:
- Glucocorticoid intramuscular injections are frequently administered for rapid musculoskeletal pain relief in outpatient settings.
- Despite being generally low-risk, these injections can lead to complications such as local infections, skin necrosis, and, rarely, severe systemic conditions like bacteraemia and multi-organ failure.
Purpose of the Study:
- To report a rare but severe complication of glucocorticoid intramuscular injections.
- To highlight the potential for serious infections, including abscess formation, even in healthy individuals.
Main Methods:
- Presentation of a clinical case study.
- Review of patient history and diagnostic findings.
Main Results:
- A healthy, immunocompetent woman in her 40s developed a retroperitoneal abscess.
- The abscess was caused by methicillin-resistant Staphylococcus aureus (MRSA).
- The infection was linked to a preceding intramuscular injection of triamcinolone.
Conclusions:
- Glucocorticoid injections, while beneficial for pain management, are associated with risks including abscess, skin necrosis, and sepsis, often from Staphylococcus aureus.
- These risks necessitate thorough patient discussion regarding potential complications, irrespective of age or comorbidities.
