Paraplegia - Possible sequelae of infected venous access site

Abstract

Background: Hospital practices of present day mostly require a peripheral venous access for a patient. Most times improper handling of these access sites results in thrombophlebitis, a reason for febrile spikes. Aim: To notify amongst health care workers, how dreadful the consequences could be due to improper handling of peripheral venous access sites. Findings: We had an interesting case of a young manual labourer treated elsewhere for over a week for fever who presented to us with painful swelling of the right forearm, suggestive of thrombophlebitis. Initial investigations suggested neutrophilic leukocytosis and biochemistry was normal. High grade fever persisted even on third day, developed severe neck tenderness and radicular pain and subsequently he developed acute quadriparesis. The initial blood culture showed Staphylococcus aureus . MRI of neck showed an epidural abscess from mid cervical to lumbar level, which was immediately drained and decompressed. With neuro-rehabilitation he regained his upper limb functions partially, but continued to have paraplegia and sphincter disturbances.