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KMID : 0363119940070010113
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Korean Journal of Pain
1994 Volume.7 No. 1 p.113 ~ p.115
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Bacterial Meningitis during Continuous Epidural Block.
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Abstract
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Bacterial meningitis is a rare complication of epidural block. As epidural abscess, subarachnoid infection associated with epidural catheters are related to the treatment of pain in diabetic patient whose immune responses have been impaired.
A 51-year-old male with non-insulin dependent diabetes came to the pain clinic with neuropathic pain on right thigh and amputated stump of right leg. Treatment consisted of continuous epidural block and subcutaneous tunnelling and epidural
morphine
with
bupivacaine was given on an outpatient basis. Two months later, the patient noted a diffuse frontal headache, projectile vomiting and stiffness neck. These symptoms became more aggrevated over the following 24 h and temperature went up to 38.4℃.
A
diagnostic lumbar puncture revealed CSF total protein of 747 mg/kl, glucose of 43 mg/dl. and 4320 WBC/㎣. Cultures of epidural catheter tip grew hemolytic staphylococcus epidermidis. A chest x-ray and brain CT scan were negative. Antibiotic
therapy
with
penicillin G and chloramphenicol was given for 15 days. Recovery was uneventful.
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