Spinal epidural abscess and meningitis following an epidural catheterisation☆

We present a case of spinal epidural abscess (SEA) following a short-term epidural catheterisation for post-operative pain relief. Preoperative investigations showed no derangement in coagulation as well as full blood counts. The diagnosis of SEA was made within three days of accidental dislodgement of the catheter. By the fifth post-operative day, signs of meningitis and methicillin resistant Staphylococcus aureus (MRSA) in the blood and from the epidural catheterisation site were identified. The microbiologist, neurologist and neurosurgeon were involved from the beginning. An early magnetic resonance image (MRI) scan, initiation of appropriate management, repeat MRI scans and regular follow-up prevented further morbidity.