Osteosynthesis and Trauma Care 2005; 13(4): 242-244
DOI: 10.1055/s-2005-872482
Original Article

© Georg Thieme Verlag Stuttgart · New York

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

S. Roemeling1 , M. van der Elst2
  • 1Department of Urology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
  • 2Department of Surgery, Reinier de Graaf Hospital, Delft, The Netherlands
Further Information

Publication History

Publication Date:
01 December 2005 (online)

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.

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Stijn RoemelingM. D. 

Erasmus MC · NH 227 · Department of Urology

P.O. Box 20 40

3000 CA Rotterdam

The Netherlands

Phone: +31/10/4 63 22 43

Fax: +31/10/4 63 53 15

Email: s.roemeling@erasmusmc.nl