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June 14, 1971

Meningitis Complicating Sacral Decubitus Ulcer

Author Affiliations

Rapid City, SD

JAMA. 1971;216(11):1866-1867. doi:10.1001/jama.1971.03180370140041

To the Editor.—  Cerebrospinal menigitis as an extension from epidural and retroperitoneal abscesses became the fatal complication of a bed-ridden patient with a sacral decubitus ulcer.

Report of a Case.—  A 54-year-old woman with severe rheumatoid arthritis, a temperature of 103 F, and a sacral decubitus ulcer for a month before admission had received little care at home and lay on her back continuously. She consumed alcohol to ease her arthritic pain and add color to her waning existence. After a week of pain in the back and malaise, this febrile, debilitated, arthritic woman appeared older than her stated age. Ankyloses of legs and neck were severe. A decubitus ulcer, 8×6 cm in size, over the sacrum extended completely through the subcutaneous tissue down to the bone.The wound was debrided extensively and cleaned daily. The white blood cell count (WBC) was 19,250/cu mm, with 87% neutrophils. Sacral x-ray film