Acute neurologic deterioration following lumbar puncture in an epidural abscess occurring 14 months after epidural catheter placement

We report the case of a 19-year-old girl admitted to the hospital with a 2- month history of back pain and a 1-week history of severe weakness, who und erwent a diagnostic lumbar puncture which was swiftly followed by acute neu rologic deterioration requiring ventilation. She was subsequently shown to have an epidural abscess extending from the second cervical to the Fifth lu mbar vertebrae. She had received uneventful epidural analgesia for childbir th 14 months previously. The case is unusual in both the acute deterioratio n following lumbar puncture, and also in the Length of time from epidural s iting to abscess formation, if this were indeed the sourer of the infection .