Spinal epidural abscess as a result of dissemination from gluteal abscess secondary to intramuscular analgesic injection.

Abstract

Spinal epidural abscess is a collection of suppurative material that forms between the dura mater and the ligamentum flavum. If not recognized early and treated correctly, it can lead to life-threatening sepsis. Here we report the case of a female patient, 51 years of age, with difficulty walking and bilateral leg pain after having had degenerative discogenic pain for many years. The patient had occasionally received intramuscular non-steroidal anti-inflammatory drug injections. The current report is that of an unusual case of epidural abscess that formed following multiple dose of intramuscular non-steroidal anti-inflammatory drug over a 1-year period. Hematogenous or direct dissemination is the suspected cause. To prevent serious morbidity and mortality, early diagnosis is essential. Patients with localized back pain who are at risk for developing such epidural spinal abscesses should receive a magnetic resonance imaging scan with contrast enhancement without delay. The existence of predisposing factors such as intramuscular injections should be considered in the assessment of suspected spinal epidural abscess.

• Authors: Mehdi Sasani, Ozlem Aydin, Ahmet Levent Aydin, Tunc Oktenoglu, Ali Fahir Ozer, Omur Ercelen
• Journal: Pain practice : the official journal of World Institute of Pain (Pain Pract) 2009 Sep-Oct Vol. 9 Issue 5 Pg. 399-403 ISSN: 1533-2500 [Electronic] United States
• PMID: 19622114 (Publication Type: Case Reports, Journal Article)

Chemical References

• Gadolinium

Topics

• Analgesia, Epidural (adverse effects)
• Back Pain (drug therapy)
• Epidural Abscess (etiology)
• Female
• Gadolinium
• Humans
• Injections, Intramuscular (adverse effects)
• Lumbar Vertebrae (pathology)
• Magnetic Resonance Imaging
• Middle Aged
• Staphylococcal Infections (complications)
• Surgical Wound Infection (complications)