Bacterial Sacroiliitis Probably Induced by Lumbar Epidural Analgesia英文文献资料.docVIP

Color profile: Disabled Default screen Composite Infect Dis Obstet Gynecol 2003;11:105–108 Bacterial sacroiliitis probably induced by lumbar epidural analgesia Shimon Edelstein and Yeouda Edoute Department of Internal Medicine C, Rambam Medical Center and the Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel Background: Properly administered, lumbar epidural analgesia provides adequate pain relief during labor and delivery, and is considered to be a safe procedure with limited complications. The prevalence of infection after lumbar epidural analgesia is negligible. Introduction: Infection of the sacroiliac joint, although very close to the pucture area, has never been reported as a procedure complication. Case: In this report, we describe a patient who experienced bacterial sacroiliitis a few days after lumbar epidural analgesia for labor. No portal of entry was identified, and we evoked a new potential risk factor that has never been proposed before, namely lumbar epidural analgesia. Conclusion: Sacroiliitis must be considered as a rare but serious complication of lumbar epidural analgesia. Key words: COMPLICATION; OSTEOMYELITIS; BONE SCAN; LUMBAR PUNCTURE CASE buttock pain. Over the next day the pain increased in intensity until she was unable to bear weight on her right leg. She was then hospitalized for evaluation. Her past medical history was un- remarkable except for allergy to penicillin, manifested by skin rash. She denied a history of trauma or drug use. On physical examination, she had a temperature of 40°C, pulse rate of 116 beats/minute, respira- tory rate of 24 breaths/minute, and blood pressure of 90/60 mmHg. She had severe pain over the right sacroiliac joint posteriorly, and pelvic compression elicited severe pain in the right sacroiliac joint. Gynecological and neurological examinations were unremarkable. A 25-year-old woman delivered a h