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Bacterial meningitis and lumbar epidural hematoma due to lumbar acupunctures: a case report
1Department of Radiology, Kaohsiung Medical College, Taiwan, Republic of China.
Abstract:
A 48-year-old female expressed signs of meningeal irritation after having received several lumbar acupunctures within one week for back pain. Bacterial meningitis was diagnosed from cerebrospinal fluid examinations. Magnetic resonance image (MRI) of spine at admission demonstrated a fusiform lesion with characters of subacute hematoma in the epidural space of the first and second lumbar level. She received antibiotics treatment only and recovered from her central nervous system infection completely. The epidural lesion disappeared spontaneously in the MRI follow up three weeks later. We report the diagnosis and follow-up of epidural hematoma of the lumbar spine by MRI which aided the medical physician to treat meningitis attentively.
Insights
A rare case of bacterial meningitis and lumbar epidural hematoma occurred after acupuncture. Magnetic resonance imaging (MRI) aided diagnosis and spontaneous resolution of the hematoma was observed.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Background:
- Acupuncture is a common treatment for back pain.
- Complications from acupuncture, though rare, can include infections and bleeding.
- Bacterial meningitis is a serious central nervous system infection.
Observation:
- A 48-year-old female developed symptoms of meningeal irritation following multiple lumbar acupuncture sessions.
- Cerebrospinal fluid analysis confirmed bacterial meningitis.
- Spinal MRI revealed a subacute epidural hematoma at the lumbar level.
Findings:
- The patient was successfully treated with antibiotics for bacterial meningitis.
- The lumbar epidural hematoma resolved spontaneously within three weeks.
- MRI was crucial for diagnosing the epidural hematoma and monitoring its resolution.
Implications:
- This case highlights the importance of considering rare complications after acupuncture.
- Prompt diagnosis and management of bacterial meningitis are critical.
- Spinal MRI is a valuable tool for identifying and tracking epidural hematomas.