Infectious Complications Associated with Temporary Epidural Catheters

To identify cases of deep-tissue or local infection associated with temporary epidural catheters, we reviewed medical records from 1980 through 1992 and prospectively followed up patients with temporary epidural catheters from January 1993 through June 1993 who were hospitalized at a large, tertiary referral hospital. We identified seven cases of temporary epidural catheter-associated infection, including three cases of deep-tissue infection (paraspinal muscle abscess, epidural abscess, and meningitis) and four cases of local infection. The infections were diagnosed 2 days to 22 days following insertion of the epidural catheter. Staphylococcus aureus was isolated in four (57%) of the cases. All seven patients were treated with removal of the catheter and antimicrobial therapy; three patients also required surgical drainage for management of deep-tissue infection. Our findings emphasize the importance of daily inspection and prompt removal of temporary epidural catheters if infection is suspected.