Spinal epidural abscess following epidural cannulation for flail chest analgesia: a case report

Peters, Nitin James; Upadhyay, Shekhar; Grewal, Sarvpreet Singh; Suini, Navdeep

doi:10.1016/s0028-3843(14)60064-5

Cited by 4 publications

(4 citation statements)

References 8 publications

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“…It was reported that several causative organisms may cause SEA, including Staphylococcus aureus , Gram-negative bacteria, coagulase-negative bacteria, staphylococcus, Escherichia coli , Pseudomonas aeruginosa , streptococcus species, and Mycobacterium spp. [2,20,21] Among them, S. aureus is the leading agent. [22] Notably, the sensitivity of blood cultural test may decline with pre-use of antibiotics.…”

Section: Discussionmentioning

confidence: 99%

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Thoracic spinal epidural abscess caused by fishbone perforation

Chen

Wang²,

Ni³

2016

Medicine

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Rationale:Ingestion of a fishbone is a common cause of esophageal injury, but spinal epidural abscess (SEA) is a rare condition due to the esophageal penetration by a swallowed fishbone. Prompt diagnosis can be seldom made owing to incomplete patient history taking and difficulties in imaging evidence identification.Patient concerns:We describe the case of a 62-year-old woman who was stuck in her throat by a fishbone, and complained of back pain, paresis of the lower limbs and fever, successively. To our knowledge, this is the first case report that we know of thoracic SEA caused by fishbone perforation.Diagnoses:About 20 days after the onset of severe back pain, she was diagnosed with SEA based on the clinical presentation and imaging findings.Interventions:Antibiotic therapy and rehabilitation therapy were carried out afterwards. However, due to exacerbation of her condition, surgical intervention had to be taken eventually.Outcomes:It is quite unfortunate for this patient to have a poor prognosis due to a delayed diagnosis and an improper management.Lessons:A number of lessons can be learnt from this case.

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Section: Discussionmentioning

confidence: 99%

“…[1,2] It is much rarer due to the esophageal penetration by a swallowed fishbone, though ingestion of a fishbone is a common cause of esophageal injury. As its low incidence limits many health care practitioners exposure to this pathology, approximately 50% of patients are initially misdiagnosed at the time of presentation.…”

Section: Introductionmentioning

confidence: 99%

Thoracic spinal epidural abscess caused by fishbone perforation

Chen

Wang²,

Ni³

2016

Medicine

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“…Although rare, ( 16 ) complications of microbial infections during anesthesia must be considered, and meningitis is one of the most important. The literature describes Staphylococcus aureus as the most frequent etiology of complications during neuroaxis regional block.…”

Section: Discussionmentioning

confidence: 99%

Comparative analysis of ampoules and vials in sterile and conventional packaging as to microbial load and sterility test

Freitas

Tardelli

2016

Einstein (São Paulo)

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Objective To compare sterility and microbial (bacteria and fungi) load in the outer part of hyperbaric bupivacaine (Neocaína®) in ampoule and bupivacaine in vial, in conventional and sterile pack formulations.Methods The sterile packs were divided into two groups: G1 (n=16) with ampoules and G2 (n=16) with vials. Conventional formulations were divided into two groups, being G3 (n=16) with ampoules and G4 (n=16) with vials. The ampoules and vials were opened and had their content drawn. The empty bottles were then placed in sterile plastic bags and sent for analysis of microbial load (bacteria and fungi) and sterility testing. Data were analyzed using the χ2 test with Yates correction, and 95% confidence interval.Results G1 and G2 showed no bacterial growth when compared to conventional groups (p<0.001). The most common agent in conventional microbiological samples was Staphylococcus aureus. There was no fungal growth in both groups.Conclusion The use of (sterile pack) reduces the microbial load of bottles, and would decrease the chance of exposure to potential contamination of the anesthetic solution.

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“…1 It was not until 1947 that Barrett and Olson made the first attempts at surgical repair of EP. 2,3 Despite update progress in intensive care, diagnostic methods, and endoscopic or surgical therapeutic measures of EP, the general mortality is still about 20%. 4 Diagnostic delays/errors due to frequent atypical clinical presentations/incomplete history, associated with the absence of clear management policies can partly explain this poor prognosis.…”

Section: Introductionmentioning

confidence: 99%

Vertebral body infection due to esophageal perforation caused by ingestion of fishbone: a case report

Zhang

Liang²,

Sun

2020

Frontiers of Nursing

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BackgroundEsophageal injury is a common complication of foreign bodies in the upper gastrointestinal tract, but bilateral pleural effusion or vertebral infection is a rare condition due to a swallowed fishbone. It is considerably difficult for a physician to diagnose quickly because of incomplete patient history of foreign bodies ingestion and/or insufficient experiences.Patient concernsWe describe the case of a 56-year-old man who was admitted to an emergency medical department owing to a low to moderate fever for 7 days. After a series of examinations, the patient was diagnosed with esophageal perforation (EP) caused by a fishbone that was swallowed half a month ago.DiagnosesAbout 12 days after the onset of fever, he was diagnosed with EP based on the gastric endoscopic images combined with histological section and sufficient history of the disease. About 2 months later, the patient has obvious back pain and lack of strength in two legs and was diagnosed with vertebral body infection.InterventionsAntibiotic therapy, multi-disciplinary team (MDT), and surgical intervention had been exerted.OutcomesIt is very fortunate for this patient to have a good prognosis due to a timely diagnosis and proper management. Muscle power has attained level 5.LessonsSeveral lessons can be learned from this case; for example, physicians should be alerted to the EP, endoscopic intervention should be prompt, antibiotics should be used regularly, and so on.

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Spinal epidural abscess following epidural cannulation for flail chest analgesia: a case report

Cited by 4 publications

References 8 publications

Thoracic spinal epidural abscess caused by fishbone perforation

Thoracic spinal epidural abscess caused by fishbone perforation

Comparative analysis of ampoules and vials in sterile and conventional packaging as to microbial load and sterility test

Vertebral body infection due to esophageal perforation caused by ingestion of fishbone: a case report

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