Introduction: Catheter-related spinal epidural abscesses are rare but increasing in incidence.Clinical Picture: An elderly gentleman received 4 days of continuous epidural analgesia following multiple traumatic rib fractures. Five days subsequently, he developed an extensive epidural abscess accompanied by backache, lower limb weakness, fever, leukocytosis and Staphylococcal bacteraemia. Treatment: He received appropriate intravenous antibiotics and underwent an emergent decompressive laminectomy. Outcome: A good outcome was achieved because of prompt diagnosis, appropriate intravenous antibiotics and timely surgical intervention. Conclusions: It is important to be vigilant and continue to maintain good clinical practice and a high index of suspicion for this procedural-related complication.
Epidural abscess complicating epidural catheterisation was first reported in 1974. Two recent studies indicated a local infection incidence of epidural catheters of 4.3% to 12% and about 0.7% are reported to have central nervous system infection e.g. epidural abscess or meningitis.
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