Unusual complication of an epidural catheter
There are the usual complications that can occur after placing an epidural catheter, such as headache, temporary nerve damage or infections. And then there are unusual complications, such as the one reported by researchers at the Augsburg Clinic in Germany.
The patient had undergone surgery for pulmonary metastases of a malignant melanoma, and initially showed no complications. After 48 hours however, the treating physicians noticed a small, conspicuous swelling above the site of epidural puncture, which was neither reddened, nor painful, nor accompanied by any neurological deficit. When questioned, the patient reported that this swelling had in fact been present for more than half a year – information that seemed to exclude the epidural catheter as cause of the swelling.
The catheter was removed on day 4, fluid was observed to drain from the puncture site – fluid that was initially deemed purulent. When questioned again about the cutaneous process and its fluid content, the patient explained that his wife had actually squeezed it out several times before. Subsequently, an MRI was performed which showed two epidermal cysts. The authors then realized that the epidural catheter had been placed through one of them. The pure culture detected Facklamia hominis and the patient was put on a 7-day antibacterial course. The happy ending: The clinical course of this patient was without any further pathological findings.