Epidural Metastatic Abscess from an Infected Femoral Head Prosthesis Presenting with Hemiplegia

Abstract

Purpose: A case of an epidural abscess with serious consequences originating from a femoral head prosthesis is reported. Methods: The history of the patient, physical examination, laboratory studies, magnetic resonance imaging, and bacteriological tests were used to reach a diagnosis, with its possible aetiology. Results: An epidural abscess was suspected because of the classical triad of febris intermittens, progressive neurological impairment and infectious parameters in the laboratory studies. Magnetic resonance imaging was used to diagnose the epidural abscess correctly, as were cultures of the hip wound, blood and epidural abscess. Conclusion: Paraplegia due to an epidural abscess is an extremely rare complication of an infected femoral head prosthesis. Nevertheless, this diagnosis should be suspected in every patient with progressive neurological impairment following a hemiarthroplasty. A delay in diagnosis can result in persisting neurological deficit or death.

Key words

hip fractures - hemiarthroplasty - epidural abscess - complication

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