Article
Life-threatening infections as iatrogenic complications of outpatient pain treatment - Report on 7 cases
Lebensbedrohliche Infektionen als Komplikationen ambulanter Schmerzbehandlung – dargestellt an 7 Fällen
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Published: | April 23, 2004 |
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Outline
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Objective
Invasive treatment of radicular pain by various methods including epidural injections, epidural catheterization and periradicular infiltrations has become very popular in Germany. Severe complications of these, mainly, outpatient procedures may occur but are rarely published.
Methods
The authors present a prospective clinical series of 7 life-threatening infections occurring within 2 years following such procedures.
Results
The patient group included 4 males and 3 females (age 32 - 71 years). There were 3 cases of pyogenic meningitis, 3 paracervical abscesses, and 1 subdural/epidural emypema/spondylitis with subsequent septicemia and multi-organ failure. Causative organisms were exclusively E.coli and Staph. aureus species. Besides proper antibiotic treatment 5 patients were operated on (one removal of a remaining lumbar catheter tip, 3 evacuations of cervical abcesses, and one spondylectomy /spondylodesis. 6 patients recovered completely; one patient died as a result of her septicemia after 6 weeks of ICU treatment.
Conclusions
Infectious complications following invasive outpatient pain treatment are often neglected. For medicolegal reasons, however, it should be kept in mind that even a "harmless" injection may lead to life-threatening complications and may even kill patients.