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Aseptic Meningitis after a Lumbar Epidural Steroid Injection -A case report-  

Hwang, Byeong Mun (Department of Anesthesiology and Pain Management, College of Medicine, University of Ulsan, Seoul Asan Medical Center)
Leem, Jung Gil (Department of Anesthesiology and Pain Management, College of Medicine, University of Ulsan, Seoul Asan Medical Center)
Publication Information
The Korean Journal of Pain / v.18, no.1, 2005 , pp. 52-55 More about this Journal
Abstract
Complications following a well conducted epidural steroid injection are rare. A 50-year-old man developed a headache and neck stiffness 2 days after a lumbar epidural steroid injection. Under the impression of aseptic meningitis, fluid and nonsteroidal anti-inflammatory drug therapy was started immediately after cerebrospinal fluid (CSF) sampling. The CSF was turbid, and revealed a white blood cell count, protein, glucose and pressure of $550/{\mu}l$ (98% lymphocyte), 107.9 mg/dl, 48 mg/dl (serum 113 mg/dl) and $17cmH_2O$, respectively. The CSF stain and culture, and antibody test and polymerase chain reaction for pathogens were negative. A computed tomography (CT) scan of the brain revealed no abnormality, and a chest roentgenogram and the results of the neurological examination were normal. Under the impression of aseptic meningitis, the condition was managed conservatively, without antibiotics. Seven days later, the clinical symptoms had improved, and the patient discharged.
Keywords
complication; epidural block; meningitis; steroid;
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