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Transverse myelitis from intraarterial penicillin
Abstract:
A child was given intramuscular benzathine penicillin and experienced manifestations of sudden, irreversible transection of the spinal cord in the lower thoracic region. The biopsy supported an intravascular injection with occlusion of the spinal vasculature as the etiological mechanism. A review of similar cases reveals a recurring pattern--intramuscular injection with standard techniques and sites into a small muscle mass without evident blood return followed by rapid progression of paralysis. The problem seems to turn upon an inability to recognize the inadvertent intraarterial injection.
Insights
Intramuscular benzathine penicillin injections can cause spinal cord transection in children. This severe complication results from inadvertent intraarterial injection, leading to paralysis.
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.