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Transverse myelitis from intraarterial penicillin.

W W Stafford, H Mena, W S Piskun

    Neurosurgery
    |October 1, 1984
    PubMed
    Summary

    Intramuscular benzathine penicillin injections can cause spinal cord transection in children. This severe complication results from inadvertent intraarterial injection, leading to paralysis.

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    Area of Science:

    • Pediatric Neurology
    • Pharmacology
    • Vascular Medicine

    Background:

    • Benzathine penicillin is commonly administered intramuscularly for various infections.
    • Proper injection technique is crucial to prevent complications.

    Observation:

    • A child developed sudden, irreversible spinal cord transection after an intramuscular benzathine penicillin injection.
    • Biopsy confirmed intravascular injection and spinal vasculature occlusion.

    Findings:

    • A review of similar cases identified a pattern of intramuscular injection into small muscle masses without blood return, followed by paralysis.
    • The etiological mechanism is inadvertent intraarterial injection, often unrecognized.

    Implications:

    • Highlights the critical need for awareness and recognition of inadvertent intraarterial injections during intramuscular procedures.
    • Emphasizes the importance of meticulous injection technique to prevent catastrophic neurological damage in pediatric patients.

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