Postlumbar puncture arachnoiditis mimicking epidural abscess

• Published in: BMJ case reports Vol. 2013; p. bcr2013200169
• Main Authors: Gürbüz, Mehmet Sabri, Erdoğan, Barıs, Yüksel, Mehmet Onur, Somay, Hakan
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 06.11.2013; BMJ Publishing Group
• Series: Case Report
• Subjects: Abscesses; Arachnoiditis - diagnosis; Arachnoiditis - etiology; Asia; Back pain; Back surgery; Cerebrospinal fluid; Cysts; Diagnosis, Differential; Diagnostic tests; Epidural; Epidural Abscess - diagnosis; Guillain-Barre syndrome; Humans; Infections; Learning from Errors; Magnetic Resonance Imaging; Male; Microorganisms; Middle Aged; Spinal cord; Spinal Puncture - adverse effects; White
• ISSN: 1757-790X; 1757-790X
• 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.