J Korean Pain Soc.  1994 May;7(1):113-115.

Bacterial Meningitis during Continuous Epidural Block

• Lee JK
• Chung JG

Abstract

Bacterial meningitis is a rare complication of epidural block. As epidural abscess, subarach noid 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 gain 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 degrees C. A diagnostic lumbar puncture revealed CSF total protein of 747 mg/dl, glucose of 43 mg/dl, and 4320 WBC/mm3. 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.

Keyword

Epidural block; Complication; Meningitis bacterial

MeSH Terms

Brain
Bupivacaine
Catheters
Chloramphenicol
Epidural Abscess
Glucose
Headache
Humans
Leg
Male
Meningitis, Bacterial*
Middle Aged
Morphine
Neck
Outpatients
Pain Clinics
Penicillin G
Spinal Puncture
Staphylococcus epidermidis
Thigh
Thorax
Tomography, X-Ray Computed
Vomiting
Bupivacaine
Chloramphenicol
Glucose
Morphine
Penicillin G