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[Peridural abscess complicating spinal anesthesia in a diabetic patient]
D Popesco1, E Fodzo, A Yagoubi
1Département d'anesthésie-réanimation A, centre hospitalo-universitaire, Amiens, France.
Abstract:
Infectious complications of spinal or epidural anaesthesia are rare, particularly after spinal anaesthesia. Most of them consist of a meningitis. We report a case of epidural abscess due to Staphylococcus aureus following spinal anaesthesia in a 62-year-old diabetic patient, diagnosed 45 days after the puncture with bacterial samples and magnetic resonance imaging. The pejorative neurological outcome required a laminectomy in spite of an efficient anti-staphylococcal treatment.
Insights
Spinal anaesthesia complications are rare, but this case shows a Staphylococcus aureus epidural abscess developing 45 days post-procedure. Despite treatment, the patient required surgery due to a poor neurological outcome.
Area of Science:
- Anesthesiology
- Infectious Diseases
- Neurosurgery
Background:
- Infectious complications following spinal or epidural anesthesia are infrequent, with meningitis being the most common.
- This case highlights a rare but serious complication: epidural abscess formation.
Observation:
- A 62-year-old diabetic patient developed symptoms 45 days after spinal anesthesia.
- Diagnosis was confirmed via bacterial sampling and magnetic resonance imaging (MRI).
Findings:
- The patient was diagnosed with an epidural abscess caused by Staphylococcus aureus.
- Despite effective anti-staphylococcal antibiotic therapy, the neurological outcome was poor.
Implications:
- This case underscores the importance of considering rare infectious complications even after a significant delay post-procedure.
- Prompt diagnosis and treatment are crucial, but surgical intervention may still be necessary for severe neurological deficits.
- Diabetic patients may represent a higher-risk group for such complications.