Paraplegia - Possible sequelae of infected venous access site

Abstract

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 and a reason for febrile spikes. We had an interesting case of a young manual laborer treated elsewhere for over a week for fever, presenting to us with painful swelling of the dorsum of left hand, suggestive of thrombophlebitis. Initial investigations suggested neutrophilic leukocytosis and biochemistry was normal. He continued to have high grade fever and on third day developed severe neck tenderness and radicular pain. The initial blood culture showed Staphylococcus aureus and he developed acute quadriparesis. The MR imaging of neck showed an epidural abscess in the mid cervical level and which was immediately drained and decompressed. With neuro-rehabilitation he regained his upper limb functions and continues to have paraplegia and sphincteric disturbances. We believe the source of infecton to be from the peripheral venous access site and recommend proper care of these access points to prevent catastrophes of this magnitude.