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Neurology (Expert Forum)
Re: chemical infection post lumbar laminectomy
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Re: chemical infection post lumbar laminectomy
by CCF neurology MD MM, Jan 01, 1995 12:00AM
Posted By CCF neuro MD MM on November 13, 1998 at 12:30:28:
In Reply to: chemical infection post lumbar laminectomy posted by blj on November 11, 1998 at 12:26:15:
I have never hear of a "chemical infection". My husband recently,(Oct 26)
had lumbar L4-L5 laminectomy with titanium cage insertion for grafting. He
was discharged from hospital Oct. 30. The only complication at that time
was a recurring fever, but at the time of discharge it was down. Nov. 3rd,
VERY suddenly he developed headache, neck ache, burning sensation in tail bone
and a fever of 103. He was transported back to the hospital, CT's and all
that were done. Main thing showing up was white count of 20,000. His
operative Dr. was out of town. The wound at the time was draining very little
and had not been draining at home. They did NOT take a culture at that time.
They hung Vancomycin, rocephin. An infectious disease dr saw him and changed
the rocephin to Fortaz. For the first 2 days in the hospital the wound drained
copious amounts of fluid and he was pretty well out of it. After the change
to Fortaz he started getting some better. Still no culture taken. The 3rd
day he was there, he was much better, fever down but one could watch the wound
drip clear fluid, which I took to be CSF. At this point the Dr cultured this
fluid. Then he put a stitch over that area hoping to stem the flow.
Thank goodness the next day his main Dr came back into town. He said the sheath
had somehow been compromised (he was very interested in the suddeness of it)
and that CSF had leaked into the surrounding tissues. This in effect caused
a chemical rx that his body had recognized as an infection and treated it as
such( high wbc, etc.) He called it a chemical infection. As my husband is
doing so much better now and will stay in hospital for observation and conti
IV antibiotics.....I am happier now, but I have never heard of a 'chemical
infection'. Could someone please explain this to me?????
The terminology used here is a little confusing, what is being described I think is an inflammatory reaction to a chemical insult.
The body reacts to foreign tissues or infection in very similar ways. This reaction involves increased blood supply causing redness, exudation of fluid, heat and pain in the area. This sequence of events occurs regardless of whether the stimulus is a bacteria, a virus, foreign material (like talc from surgeons gloves) or our own bodily fluids which have entered the wrong area.
In this case it would appear that CSF leaked into muscle setting up an inflammatory reaction which is indistinguishable from an infection, thence the term chemical infection.
Since there is a break in the CSF barrier this should be covered with antibiotics, it seems like your husband is in good hands, I hope this explains your dilemma, and that he continues to improve.
In Reply to: chemical infection post lumbar laminectomy posted by blj on November 11, 1998 at 12:26:15:
I have never hear of a "chemical infection". My husband recently,(Oct 26)
had lumbar L4-L5 laminectomy with titanium cage insertion for grafting. He
was discharged from hospital Oct. 30. The only complication at that time
was a recurring fever, but at the time of discharge it was down. Nov. 3rd,
VERY suddenly he developed headache, neck ache, burning sensation in tail bone
and a fever of 103. He was transported back to the hospital, CT's and all
that were done. Main thing showing up was white count of 20,000. His
operative Dr. was out of town. The wound at the time was draining very little
and had not been draining at home. They did NOT take a culture at that time.
They hung Vancomycin, rocephin. An infectious disease dr saw him and changed
the rocephin to Fortaz. For the first 2 days in the hospital the wound drained
copious amounts of fluid and he was pretty well out of it. After the change
to Fortaz he started getting some better. Still no culture taken. The 3rd
day he was there, he was much better, fever down but one could watch the wound
drip clear fluid, which I took to be CSF. At this point the Dr cultured this
fluid. Then he put a stitch over that area hoping to stem the flow.
Thank goodness the next day his main Dr came back into town. He said the sheath
had somehow been compromised (he was very interested in the suddeness of it)
and that CSF had leaked into the surrounding tissues. This in effect caused
a chemical rx that his body had recognized as an infection and treated it as
such( high wbc, etc.) He called it a chemical infection. As my husband is
doing so much better now and will stay in hospital for observation and conti
IV antibiotics.....I am happier now, but I have never heard of a 'chemical
infection'. Could someone please explain this to me?????
The terminology used here is a little confusing, what is being described I think is an inflammatory reaction to a chemical insult.
The body reacts to foreign tissues or infection in very similar ways. This reaction involves increased blood supply causing redness, exudation of fluid, heat and pain in the area. This sequence of events occurs regardless of whether the stimulus is a bacteria, a virus, foreign material (like talc from surgeons gloves) or our own bodily fluids which have entered the wrong area.
In this case it would appear that CSF leaked into muscle setting up an inflammatory reaction which is indistinguishable from an infection, thence the term chemical infection.
Since there is a break in the CSF barrier this should be covered with antibiotics, it seems like your husband is in good hands, I hope this explains your dilemma, and that he continues to improve.
