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[脊髓麻醉下剖宫产术后人型支原体所致硬脑膜下积脓]

[Subdural empyema due to Mycoplasma hominis after a cesarean section under spinal anesthesia].

作者信息

Delgado Tapia J A, Galera López J, Santiago Martín J, Galdo Abadín J R, Quirante Pizarro A, Cánovas Fernández E, García Villalba F

机构信息

Hospital Torrecárdenas de Almería.

出版信息

Rev Esp Anestesiol Reanim. 2005 Apr;52(4):239-42.

Abstract

The isolation of Mycoplasma hominis in cultured biopsy material from a subdural empyema is a very rare finding. Likewise, subdural empyema complicating epidural anesthesia is an uncommon event after cesarean delivery. We report the case of a 32-year-old patient who presented a throbbing headache when standing 48 hours after undergoing cesarean delivery under spinal anesthesia. On the fifth day after surgery, the headache worsened, fever developed, and an abscess was detected at the abdominal wall; antibiotic treatment was prescribed. When fever and headache persisted and abdominal infection had been ruled out, nuclear magnetic resonance imaging of the head revealed subdural empyema. Emergency surgery to drain pus was carried out twice. Mycoplasma hominis was isolated from a blood-agar culture of the exudate. The patient recovered fully after combined surgical and antibiotic treatment.

摘要

从硬膜下积脓的培养活检材料中分离出人型支原体是非常罕见的发现。同样,硬膜下积脓并发硬膜外麻醉在剖宫产术后也是不常见的情况。我们报告一例32岁患者,在脊髓麻醉下行剖宫产术后48小时站立时出现搏动性头痛。术后第五天,头痛加重,出现发热,腹壁发现脓肿,给予抗生素治疗。当发热和头痛持续且排除腹部感染后,头部核磁共振成像显示硬膜下积脓。紧急进行了两次引流脓液的手术。从渗出物的血琼脂培养物中分离出人型支原体。患者经手术和抗生素联合治疗后完全康复。

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