Epidural Abscess and Meningitis after Epidural Corticosteroid Injection

W. Michael Hooten, Michelle O. Kinney, Marc A. Huntoon

Research output: Contribution to journalArticle

77 Scopus citations

Abstract

Epidural abscess with and without associated meningitis after epidural corticosteroid injections for radicular back pain is a rarely reported complication. We report the occurrence of an epidural abscess and meningitis in a 70-year-old man after 2 epidural corticosteroid injections for treatment of acute radicular lumbar back pain. At the time of diagnosis, cerebrospinal fluid cultures grew Staphylococcus aureus, and the patient was treated with intravenous antibiotics. Possible predisposing factors for the development of an epidural abscess and meningitis in this patient include a 2-year history of neutropenia and an accidental dural puncture that occurred during performance of the first epidural injection. A literature search identified 11 reported cases of epidural abscess, 2 of epidural abscess and meningitis, and 1 of meningitis attributed to epidural corticosteroid injections. Eight of the 14 reported patients were immunocompromised, and 8 (67%) of the 12 in whom cultures of blood, cerebrospinal fluid, or epidural pus were performed had results positive for S aureus. Antibiotic prophylaxis for S aureus should be considered for immunocompromised patients undergoing epidural corticosteroid injections.

Original languageEnglish (US)
Pages (from-to)682-686
Number of pages5
JournalMayo Clinic proceedings
Volume79
Issue number5
DOIs
StatePublished - May 2004

ASJC Scopus subject areas

  • Medicine(all)

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