Gürbüz Mehmet Sabri, Erdoğan Baris, Yüksel Mehmet Onur, Somay Hakan
Department of Neurosurgery, Ağrı Public Hospital, Ağrı, Turkey.
BMJ Case Rep. 2013 Nov 6;2013:bcr2013200169. doi: 10.1136/bcr-2013-200169.
Lumbar spinal arachnoiditis occurring after diagnostic lumbar puncture is a very rare condition. Arachnoiditis may also present with fever and elevated infection markers and may mimic epidural abscess, which is one of the well known infectious complications of lumbar puncture. We report the case of a 56-year-old man with lumbar spinal arachnoiditis occurring after diagnostic lumbar puncture who was operated on under a misdiagnosis of epidural abscess. In the intraoperative and postoperative microbiological and histopathological examination, no epidural abscess was detected. To our knowledge, this is the first case of a patient with postlumbar puncture arachnoiditis operated on under a misdiagnosis of epidural abscess reported in the literature. The authors suggest that arachnoiditis may mimic epidural abscess due to its clinical and radiological features and should be considered in the differential diagnosis of complications of lumbar puncture.
诊断性腰椎穿刺后发生的腰椎蛛网膜炎是一种非常罕见的疾病。蛛网膜炎也可能伴有发热和感染指标升高,并且可能类似于硬膜外脓肿,硬膜外脓肿是腰椎穿刺众所周知的感染性并发症之一。我们报告了一例56岁男性患者,在诊断性腰椎穿刺后发生腰椎蛛网膜炎,因误诊为硬膜外脓肿而接受了手术。在术中及术后的微生物学和组织病理学检查中,未发现硬膜外脓肿。据我们所知,这是文献中报道的首例因误诊为硬膜外脓肿而接受手术的腰椎穿刺后蛛网膜炎患者。作者认为,蛛网膜炎因其临床和放射学特征可能类似于硬膜外脓肿,在腰椎穿刺并发症的鉴别诊断中应予以考虑。