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J Neurocrit Care 2013;6(2): 119-121.
경막외 자가조절진통 후 발생한 메티실린 내성 황색포도알균 수막염
건양대학교 의과대학 신경과학교실
Methicillin-Resistant Staphylococcus aureus Meningitis after Epidural Patient-Controlled Analgesia
Inwoo Yu, MD, Jae-Hwan Kim, MD, Kee Ook Lee, MD, Bora Yoon, MD, PhD, Yong-Duk Kim, MD, PhD, and Sang-Jun Na, MD, PhD
Department of Neurology, Konyang University College of Medicine, Daejeon, Korea
Background: Staphylococcus aureus (SA) meningitis is very rare but fatal in adults. As methicillin-resistant Staphylococcus aureus (MRSA) infection has increased, the incidence of MRSA meningitis also increased recently. We report a patient with MRSA meningitis after epidural patient-controlled analgesia (PCA).
Case Report: A 56-year-old man was admitted for multiple bone fractures. He was complaining of severe chest wall pain, so epidural PCA was inserted. After epidural PCA, he developed fever and headache caused by MRSA meningitis. Empiric antibiotics therapy was started. He was discharged from hospital without neurologic sequelae.
Conclusions: Epidural PCA should be performed under aseptic condition. If patient complains of headache and fever after epidural PCA, physician should perform cerebrospinal fluid study to rule out bacterial meningitis.
Key Words: Methicillin-resistant Staphylococcus aureus · Meningitis · Epidural patient-controlled analgesia
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