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Epidural Abscess after Implantation of Epidural Port in Cancer Pain Patient -A case report-  

Lee, Seung Yun (Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital)
Kang, Mae Hwa (Department of Anesthesiology, Seoul National University College of Medicine)
Kim, Yang Hyun (Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital)
Lee, Pyung Bok (Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital)
Publication Information
The Korean Journal of Pain / v.19, no.2, 2006 , pp. 266-270 More about this Journal
Abstract
A case of an epidural abscess, a rare but possibly devastating complication of epidural instrumentation and catheterization, which occurred in a cancer pain patient with an epidural port connected to the epidural catheter, is described. Although cases of a catheter related epidural abscess have been intermittently reported, those following epidural port implantation are very rare, with no case having been reported in Korea. Herein, the case of a 31-year-old man, who developed an epidural abscess 54 days after subcutaneous implantation of an epidural port connected to an epidural catheter, is reported. Methicillin-sensitive staphylococcus aureus was detected in a culture of the purulent discharge. Magnetic resonance imaging was essential, not only for the diagnosis of the epidural abscess, but also for determining the extent of spread. The patient refused further evaluation and treatment, and expired 22 days later.
Keywords
epidural abscess; epidural port;
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1 de Jong PC, Kansen PJ: A comparison of epidural catheters with or without subcutaneous injection ports for treatment of cancer pain. Anesrh Analg 1994; 78: 94-100
2 Holt HM, Andersen SS, Andersen O, Gahrn-Hansen B, Siboni K: Infection following epidural catheterization. J Hosp Infect 1995; 30: 253-60
3 Sakuragi T, Yanagisawa K, Dan K: Bactericidal activity of skin disinfectants on methicillin-resistant staphylococcus aureus. Anesth Analg 1995; 81: 555-8   DOI
4 Sleth JC: Evaluation of aseptic measures in the performance of pidural catheterization and perception of its risk of infection. Results of a survey in Languedoc-Roussillon. Ann Fr Anesth Reanim 1998; 17: 408-14   DOI   ScienceOn
5 Wang LP, Hauerberg J, Schmidt JF: Incidence of spinal epidural abscess after epidural analgeisa: a national 1-year survey. Anesthesiology 1999; 91: 1928-36   DOI   ScienceOn
6 Kee WD, Jones MR, Thomas P, Worth RJ: Extradural abscess complicating extradural anaesthesia for caesarean section. Br J Anaesth 1992; 69: 647-52   DOI   ScienceOn
7 Hlavin ML, Kaminski HJ, Ross JS, Ganz E: Spinal epidural abscess: a ten-year perspective. Neurosurgery 1990; 27: 177-84   DOI
8 Royakkers AA, Willigers H, van der Ven AJ, Wilmink J, Durieux M, van Kleef M: Catheter-related epidural abscess-don't wait for neurological deficits. Acta Anaesthesiol Scand 2002; 46: 611-5   DOI   ScienceOn
9 Chang SH, Koo EH, Lim HJ, Cho H, Lee HW, Yoon SM: Epidural abscess following continuous epidural analgesia in patient with rectal cancer. Korean J Pain 1998; 11: 165-8
10 Horlocker TT, Wedel DJ: Spinal and epidural blockade and perioperative low molecular weight heparin: smooth sailing on the Titanic. Anesth Analg 1998; 86: 1153-6   DOI
11 Du Pen SL, Peterson DG, Williams A, Bogosian AJ: Infection during chronic epidural catheterization: diagnosis and treatment. Anesthesiology 1990; 73: 905-9   DOI   ScienceOn
12 Kost-Byerly S, Tobin JR, Greenberg RS, Billett C, Zahurak M, Yaster M: Bacterial colonization and infection rate of continuous epidural catheters in children. Anesth Analg 1998; 86: 712-6   DOI
13 De Cicco M, Matovic M, castellani GT, Basaglia G, Santini G, Del Pup C, et al: Time-dependent efficacy of bacterial filters and infection risk in long-term epidural carhererization. Anesthesiology 1995; 82: 765-71   DOI   ScienceOn
14 Dahlgren N, Tornebrandt K: Neurological complications after anaesthesia. A follow-up of 18,000 spinal and epidural anaesthetics performed over three years. Acta Anaesthesiol Scand 1995; 39: 872-80   DOI   ScienceOn
15 Okano K, Kondo H, Tsuchiya R, Naruke T, Sato M, Yokoyama R: Spinal epidural abscess associated with epidural catheterization: report of a case and a review of the literature. Jpn J Clin Oncol 1999; 29: 49- 52   DOI   ScienceOn
16 Hernandez JM, Coyle FP, Wright CD, Ballantyne JC: Epidural abscess after epidural anesthesia and continuous epidural analgesia in at patient with gastric lymphoma. J Clin Anesth 2003; 15: 48- 51   DOI   ScienceOn
17 Rigamonti D, Liem L, Sampath P, Knoller N, Namaguchi Y, Schreibman DL, el al: Spinal epidural abscess: contemporary trends in etiology, evaluation, and management. Surg Neurol 1999; 52: 189-96   DOI   ScienceOn
18 Dtiessen JJ, de Mulder PH, Claessen JJ, van Diejen D, Wobbes T: Epidural administration of morphine for control of cancer pain: long-term efficacy and complications. Clin J Pain 1989; 5: 217-22   DOI   ScienceOn
19 Cleeland CS, Gonin R, Hatfield AK, Edmonson JH, Blum RH, Stewart JA, et al: Pain and its treatment in outpatients with metastatic cancer. N Engl J Med 1994; 330: 592-6   DOI   ScienceOn
20 Smitt PS, Tsafka A, Teng-van de Zande F, van der Holt R, Elswijk-de Vries I, Elfrink E, et al: Outcome and complications of epidural analgesia in patients with chronic cancer pain. Cancer 1998; 83: 2015-22   DOI   ScienceOn