Catheter induced spinal epidural abscess in dialysis patients: A
Systematic review of descriptive studies
Abstract
ABSTRACT Purpose: Recently, there is an increased number of reports
being published on catheter-induced spinal epidural abscess (SEA). This
review aims to identify and critically evaluate all the descriptive
studies that report the SEA due to catheterization and its presentation,
diagnosis, management, and outcomes. Methodology: A literature search
was performed in the PubMed database using MeSH terms “epidural
abscess” AND “renal dialysis” from inception to January 2021 without
any language restriction. Google Scholar, grey literature databases
(GreyNet. OpenGrey, Grey literature Report, BIOSIS Previews), and the
bibliographic search of included studies were carried out to find the
additional studies. Descriptive studies describing the SEA induced by
catheter usage were included in the review. Study selection, data
extraction, and quality assessment were conducted by two independent
reviewers any disagreement was resolved by discussing with the third
reviewer. Results: Data of 6 studies were retrieved for this review
which includes 11 patients (5 females and 6 males) aged from 26 to 79
years old. The most common patient’s presentation was back pain,
high-grade fever, quadriparesis, neck pain, drowsy, and altered mental
status. The most common isolated microorganism from the blood and
catheter tip was Methicillin-resistant Staphylococcus aureus. The most
common findings in all the patients were elevated erythrocyte
sedimentation rate and leucocyte count. Conclusion: Clinicians must be
aware of the possibilities of SEA initiated by catheter usage to prevent
further consequences. Aggressive antibiotic therapy along with surgical
intervention are the cornerstones in the management of SEA. Early
diagnosis and initiation of treatment are important factors that decide
the mortality and morbidity in patients with SEA. Keywords: Catheter;
Dialysis; Spinal epidural abscess; Systematic review; Case report
Protocol registration: International Prospective Register for Systematic
Reviews (PROSPERO) ID: CRD42021233375