The article discusses a case of an extensive epidural lumbar abscess in a young and otherwise healthy non-comorbid male patient after a therapeutic nerve root block. The patient required surgical interventions and antibiotic therapy. The article also reviews 18 other cases of epidural abscesses after spinal injections, finding that symptoms typically occurred 8 days after the procedure, but correct diagnosis was made around 25 days later. Most patients experienced neurological sequelae and the most common isolated germ was Staphylococcus Aureus. The conclusion emphasizes the importance of maintaining a diagnostic suspicion for epidural abscesses, even in young patients without comorbidities
Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : top spinal clinic on Harley Street UK
Published article
Epidural abscesses are infrequent and serious, complication after spinal diagnostic and therapeutic injections, even in young patients without comorbidities. We consider it fundamental to maintain a diagnostic suspicion, even in this subgroup of patients.
Spine nerve root injection dorsal root ganglion transforaminal Expert. Best Spinal Surgeon UK
Abstract in English, Spanish Introduction: Epidural injections are frequent and safe procedures. Severe complications are infrequent, and they have been reported in elderly comorbid patients with predisposing factors. The objectives of this work are to present a case of an extensive epidural lumbar abscess in a young non-comorbid male patient after a therapeutic L5-S1 injection,
Abstract
Introduction: Epidural injections are frequent and safe procedures. Severe complications are infrequent, and they have been reported in elderly comorbid patients with predisposing factors. The objectives of this work are to present a case of an extensive epidural lumbar abscess in a young non-comorbid male patient after a therapeutic L5-S1 injection and a literature review about this subject.
Case presentation: An otherwise healthy 24-year-old man who present a case of an extensive epidural lumbar abscess after a therapeutic nerve root block due to a disc herniation. After 7 days of fever and low back pain, he required two surgical interventions and intravenous antibiotic therapy. We reviewed 18 patients with epidural abscess consequence of spinal injections. Their mean age was 54.5 y.o, 66.5% were male, and 66.5% had at least one predisposing risk factor. Symptoms Onset occurred at 8 days on average after the procedure, but the correct diagnosis was made at the 25th-day average. Only 22% presented the classic diagnostic triad, the most frequently isolated germ was Staphylococcus Aureus (66%) and 89% were treated surgically with a 33% rate of complete recovery, 17% mortality and 28% remained with neurological sequelae.
Epidural abscesses are infrequent and serious, complication after spinal diagnostic and therapeutic injections, even in young patients without comorbidities. We consider it fundamental to maintain a diagnostic suspicion, even in this subgroup of patients.
Introduction: Periradicular blocks are a common and safe practice. Severe complications, such as epidural abscesses, are rare and have been reported in elderly patients with comorbidities or predisposing factors. The objective of this work is to present a young patient with no history diagnosed with an epidural abscess after a therapeutic block and to review the literature on the matter.
Presentation of the case: A previously healthy 24-year-old man presents a case of extensive lumbar epidural abscess after a periradicular block from a herniated disc. After 7 days of fever and low back pain, he required two surgeries and intravenous antibiotic therapy. We collected the information of 18 cases together with ours, of patients with a diagnosis of epidural abscess as a consequence of a spinal infiltration. The mean age of the patients was 54.5 years, 66.5% were male, and 66.5% had at least one predisposing risk factor. The onset of symptoms after the block occurred an average of 8 days, but the diagnosis of abscess was made at an average of 24 days. The classic diagnostic triad was only present in 22%, the most frequently isolated germ was Staph. aureus (66%) and 89% were treated surgically with a rate of 33% complete recovery, 17% mortality, and 28% neurological sequelae.
Epidural abscesses are an uncommon, serious, and rare complication of spinal diagnostic and therapeutic procedures, even in young patients without comorbidities. We consider it necessary to maintain diagnostic suspicion, even in this subgroup of patients.
Keywords: epidural abscess; spine, infections; injections epidural.
The London Spine Unit : top spinal clinic on Harley Street UK
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Extensive spinal epidural abscess after nerve root injection in a young non-immunocompromised Patient. Case Report and Literature Review
