Spinal epidural abscess in a juvenile dog

2005 ◽  
Vol 18 (03) ◽  
pp. 186-188 ◽  
Author(s):  
W. B. Thomas ◽  
C. W. Schmiedt
Keyword(s):  
Epidural Space ◽  
Rectal Temperature ◽  
Epidural Abscess ◽  
Spinal Pain ◽  
Neurological Deficits ◽  
Spinal Epidural Abscess ◽  
Intact Female ◽  
Haemolytic Streptococcus ◽  
Spinal Epidural

SummaryA six-month-old, intact female, Miniature Pinscher was admitted with signs of progressive neurological deficits in the hind legs, an elevated rectal temperature, and spinal pain of 48 hours duration. A myelogram was performed which demonstrated a dorsal, left sided compressive lesion extending from T11-T13. A leftsided hemilaminectomy was performed from T11-T13. A friable, poorly organized, pale tan and red mass was identified within the epidural space. Cytopathological and histopathological analyses of the mass demonstrated marked, subacute, suppurative cellulitis. A culture of the purulent material revealed beta haemolytic Streptococcus sp.

scholarly journals Rapidly Progressive Spontaneous Spinal Epidural Abscess

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Abdurrahman Aycan ◽  
Ozgür Yusuf Aktas ◽  
Feyza Karagoz Guzey ◽  
Azmi Tufan ◽  
Cihan Isler ◽  
...  
Keyword(s):  
Epidural Abscess ◽  
Delayed Diagnosis ◽  
Clinical Findings ◽  
Neurological Deficits ◽  
Spinal Epidural Abscess ◽  
Low Back ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Paraspinal Abscess ◽  
Spinal Epidural

Spinal epidural abscess (SEA) is a rare disease which is often rapidly progressive. Delayed diagnosis of SEA may lead to serious complications and the clinical findings of SEA are generally nonspecific. Paraspinal abscess should be considered in the presence of local low back tenderness, redness, and pain with fever, particularly in children. In case of delayed diagnosis and treatment, SEA may spread to the epidural space and may cause neurological deficits. Magnetic resonance imaging (MRI) remains the method of choice in the diagnosis of SEA. Treatment of SEA often consists of both medical and surgical therapy including drainage with percutaneous entry, corpectomy, and instrumentation.

scholarly journals Spinal Epidural Abscess İn An Adolescent (Case Report)

2021 ◽  
Author(s):  
Meryem Badem ◽  
Serpil Ugur Baysal ◽  
İlknur Karyağdı ◽  
Nusret Oren ◽  
Hamit Selim Karabekir ◽  
...  
Keyword(s):  
Medical Literature ◽  
Epidural Abscess ◽  
Surgical Intervention ◽  
Neurological Deficits ◽  
Spinal Epidural Abscess ◽  
Spinal Magnetic Resonance Imaging ◽  
Serious Infection ◽  
English Medical Literature ◽  
Spinal Epidural ◽  
Systemic Antibiotics

Spinal infections in immunocompetent children are very rare. But it is a serious infection in the epidural space along the spinal cord. It should be considered in patients with backache, fever, neurological deficits and/or spinal tenderness. There are cases which an etiology could not determined. In the English medical literature, there are only 31 reported pediatric cases in the last two decades. In children with neurologic deficits, surgery combined with systemic antibiotics constitutes the optimal therapy. We report a case of thoracal spinal epidural abscess in a 12-year-old adolescent boy who was immunocompetent and presented with spinal tenderness, back pain and four days of fever. A spinal magnetic resonance imaging demonstrated an epidural abscess between T2 and T10 level. An emergent surgical intervention was applied. Cultures remained negative. He was given systemic antibiotics for six weeks. He recovered without any sequelae.

scholarly journals Extensive spinal epidural abscess treated with “apical laminectomies” and irrigation of the epidural space: report of 2 cases

2015 ◽  
Vol 22 (3) ◽  
pp. 318-323 ◽  
Author(s):  
Muhammad M. Abd-El-Barr ◽  
Wenya Linda Bi ◽  
Biji Bahluyen ◽  
Samuel T. Rodriguez ◽  
Michael W. Groff ◽  
...  
Keyword(s):  
Blood Loss ◽  
Epidural Space ◽  
Epidural Abscess ◽  
Feeding Tube ◽  
Spinal Epidural Abscess ◽  
Fogarty Catheter ◽  
Mechanical Instability ◽  
Increased Risk ◽  
Infectious Burden ◽  
Spinal Epidural

Spinal epidural abscess (SEA) is a rare but often devastating infection of the epidural space around the spinal cord. When an SEA is widespread, extensive decompression with laminectomy is often impossible, as it may subject the patient to very long operative times, extensive blood loss, and mechanical instability. A technique called “skip laminectomy” has been described in the literature, in which laminectomies are performed at the rostral and caudal ends of an abscess that spans 3–5 levels and a Fogarty catheter is used to mechanically drain the abscess, much like in an embolectomy. In this report of 2 patients, the authors present a modification of this technique, which they call “apical laminectomies” to allow for irrigation and drainage of an extensive SEA spanning the entire length of the vertebral column (C1–2 to L5–S1). Two patients presented with cervico-thoraco-lumbar SEA. Laminectomies were performed at the natural apices of the spine, namely, at the midcervical, midthoracic, and midlumbar spine levels. Next, a pediatric feeding tube was inserted in the epidural space from the thoracic laminectomies up toward the cervical laminectomy site and down toward the lumbar laminectomy site, and saline antibiotics were used to irrigate the SEA. Both patients underwent this procedure with no adverse effects. Their SEAs resolved both clinically and radiologically. Neither patient suffered from mechanical instability at 1 year after treatment. For patients who present with extensive SEAs, apical laminectomies seem to allow for surgical cure of the infectious burden and do not subject the patient to extended operating room time, an increased risk of blood loss, and the risk of mechanical instability.

scholarly journals An institutional series and contemporary review of bacterial spinal epidural abscess: current status and future directions

2014 ◽  
Vol 37 (2) ◽  
pp. E9 ◽  
Author(s):  
Faris Shweikeh ◽  
Kashif Saeed ◽  
Laura Bukavina ◽  
Stephanie Zyck ◽  
Doniel Drazin ◽  
...  
Keyword(s):  
Literature Search ◽  
Epidural Abscess ◽  
Early Recognition ◽  
Thoracolumbar Spine ◽  
Signs And Symptoms ◽  
Neurological Deficits ◽  
Current Status ◽  
Spinal Epidural Abscess ◽  
Presenting Symptoms ◽  
Spinal Epidural

Object Over the past decade, the incidence of bacterial spinal epidural abscess (SEA) has been increasing. In recent years, studies on this condition have been rampant in the literature. The authors present an 11-year institutional experience with SEA patients. Additionally, through an analysis of the contemporary literature, they provide an update on the challenging and controversial nature of this increasingly encountered condition. Methods An electronic medical record database was used to retrospectively analyze patients admitted with SEA from January 2001 through February 2012. Presenting symptoms, concurrent conditions, microorganisms, diagnostic modalities, treatments, and outcomes were examined. For the literature search, PubMed was used as the search engine. Studies published from January 1, 2000, through December 31, 2013, were critically reviewed. Data from articles on methodology, demographics, treatments, and outcomes were recorded. Results A total of 106 patients with bacterial SEA were identified. The mean ± SD age of patients was 63.3 ± 13.7 years, and 65.1% of patients were male. Common presenting signs and symptoms were back pain (47.1%) and focal neurological deficits (47.1%). Over 75% of SEAs were in the thoracolumbar spine, and over 50% were ventral. Approximately 34% had an infectious origin. Concurrent conditions included diabetes mellitus (35.8%), vascular conditions (31.3%), and renal insufficiency/dialysis (30.2%). The most commonly isolated organism was Staphylococcus aureus (70.7%), followed by Streptococcus spp. (6.6%). Surgery along with antibiotics was the treatment for 63 (59.4%) patients. Surgery involved spinal fusion for 19 (30.2%), discectomy for 14 (22.2%), and corpectomy for 9 (14.3%). Outcomes were reported objectively; at a mean ± SD follow-up time of 8.4 ± 26 weeks (range 0–192 weeks), outcome was good for 60.7% of patients and poor for 39.3%. The literature search yielded 40 articles, and the authors discuss the result of these studies. Conclusions Bacterial SEA is an ominous condition that calls for early recognition. Neurological status at the time of presentation is a key factor in decision making and patient outcome. In recent years, surgical treatment has been advocated for patients with neurological deficits and failed response to medical therapy. Surgery should be performed immediately and before 36–72 hours from onset of neurological sequelae. However, the decision between medical or surgical intervention entails individual patient considerations including age, concurrent conditions, and objective findings. An evidence-based algorithm for diagnosis and treatment is suggested.

scholarly journals Pneumorachis from the cervical to the sacral spinal canal with spinal epidural abscess by gas gangrene

2019 ◽  
Vol 27 (2) ◽  
pp. 230949901986007
Author(s):  
Tomoki Matsuo ◽  
Atsushi Tanji ◽  
Koichi Tateyama ◽  
Yuhei Yoda ◽  
Yusaku Kamata ◽  
...  
Keyword(s):  
Spinal Canal ◽  
Epidural Abscess ◽  
Rare Condition ◽  
Gas Gangrene ◽  
Neurological Deficits ◽  
Spinal Epidural Abscess ◽  
Laboratory Findings ◽  
Severe Diabetes ◽  
Spinal Epidural

We present a 70-year-old woman with severe diabetes mellitus, who experienced low back pain and left lower leg paralysis. Computed tomography showed air in the spinal canal from C4 to S5, and magnetic resonance imaging revealed an epidural abscess from Th11 to L1. Laboratory findings showed increases in inflammatory indicators and blood culture indicated the presence of Escherichia coli. The patient was treated conservatively with antibiotics. Neurological deficits and inflammatory data improved during the course. Follow-up imaging studies showed the disappearance of gas and epidural abscess. The existence of air in the spinal canal is a rare condition known as pneumorachis. To the best of our knowledge, such a long pneumorachis ranging from the cervical to the sacral spinal canal with epidural abscess caused by gas gangrene has not yet been described. We should therefore realize the possibility of epidural abscess produced by gas gangrene and treat it appropriately.

The pathogenesis of spinal epidural abscess: microangiographic studies in an experimental model

1988 ◽  
Vol 69 (1) ◽  
pp. 110-114 ◽  
Author(s):  
John A. Feldenzer ◽  
Paul E. McKeever ◽  
Dennis R. Schaberg ◽  
John A. Campbell ◽  
Julian T. Hoff
Keyword(s):  
Spinal Cord ◽  
Experimental Model ◽  
Spinal Cord Compression ◽  
Epidural Space ◽  
Epidural Abscess ◽  
Vascular Anatomy ◽  
Cord Compression ◽  
Spinal Epidural Abscess ◽  
Content Type ◽  
Spinal Epidural

✓ An experimental model of spinal epidural abscess was developed in rabbits by injecting Staphylococcus aureus into the posterior thoracolumbar epidural space. This model has been shown to reproduce the neurological, bacteriological, and radiological aspects of the human disease. In this study, the effect of the infectious epidural mass on the vasculature of the spinal cord in paraplegic rabbits was studied using microangiographic techniques. The normal vascular anatomy of the rabbit spinal cord was defined in control experiments. Vascular proliferation was demonstrated in the epidural space surrounding the abscesses. Anterior and paired posterior spinal arteries remained patent in paraplegic rabbits with mild or moderate spinal cord compression and in some cases of severe compression. In animals with severe compression, the anterior epidural venous plexus remained patent, but the dorsal spinal vein was occluded. Occlusion of perforating arteries occurred only with extreme spinal cord compression. These data indicate that the initial neurological deficit associated with experimental spinal epidural abscess is not due to vascular thrombosis.

scholarly journals Holocord spinal epidural abscess in a pregnant patient presenting as premature labour: a rare presentation of an unusual diagnosis

CJEM ◽  
2014 ◽  
Vol 16 (04) ◽  
pp. 334-338 ◽  
Author(s):  
Kirsteen R. Burton ◽  
Xi Wang ◽  
Deljit Dhanoa
Keyword(s):  
Epidural Space ◽  
Epidural Abscess ◽  
Pregnant Patient ◽  
Foramen Magnum ◽  
Motor Dysfunction ◽  
Lumbar Pain ◽  
Spinal Epidural Abscess ◽  
Rare Presentation ◽  
Spinal Epidural ◽  
Pelvic Pressure

ABSTRACT Spinal epidural abscess (SEA) is a rare clinical entity. It is less common when the entire epidural space is involved, known as a holocord or panspinal SEA, and it is even less common in a pregnant patient. We report a case of methicillin-resistant Staphylococcus aureus holocord SEA in a 30-year-old female at approximately 22 weeks' gestational age who presented with lumbar pain and pelvic pressure and the urge to bear down. Magnetic resonance imaging of the spine demonstrated extensive SEA and meningitis from the foramen magnum to the lumbar spine that was treated both medically and surgically. The incidence of, clinical presentation of, and risk factors for developing SEA are discussed. If untreated, expanding SEAs produce sensory symptoms and signs, motor dysfunction, and, eventually, paralysis and death. The medical and surgical management of SEA is also discussed. SEA can have an insidious and atypical presentation despite extensive involvement of the epidural space. Therefore, the diagnosis of SEA should always be considered in patients who present to the emergency department with back pain.

scholarly journals Spinal Epidural Abscess: A Review with Special Emphasis on Earlier Diagnosis

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Allison Bond ◽  
Farrin A. Manian
Keyword(s):  
Epidural Abscess ◽  
Significant Proportion ◽  
Simple Algorithm ◽  
Neurological Deficits ◽  
Spinal Epidural Abscess ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
Objective Evidence ◽  
Spinal Epidural

Spinal epidural abscess (SEA) is an uncommon but serious condition with significant morbidity and mortality. The prognosis of SEA is highly dependent on the timeliness of its diagnosis before neurological deficits develop. Unfortunately, often due to its nonspecific presentation, such as back pain, the diagnosis of SEA may be delayed in up to 75% of cases. Although many risk factors for SEA can be found in the published literature, their utility is limited by their frequent lack of objective evidence, numerousness, and absence in a significant proportion of cases. In this review, we call for a more discriminate evidence-based use of the term “risk factor” when discussing SEA and explore several approaches to its earlier diagnosis, including a simple algorithm based on its pathophysiology and serum C-reactive protein or erythrocyte sedimentation rate.

Surgical Treatment of Patients With Spondylodiscitis and Neurological Deficits Caused by Spinal Epidural Abscess (SEA) is a Predictor of Clinical Outcome

2014 ◽  
Vol 27 (7) ◽  
pp. 395-400 ◽  
Author(s):  
Björn P. Robach ◽  
Thomas R. Niethammer ◽  
Alexander C. Paulus ◽  
Carolin Melcher ◽  
Christof Birkenmaier ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Clinical Outcome ◽  
Epidural Abscess ◽  
Neurological Deficits ◽  
Spinal Epidural Abscess ◽  
Spinal Epidural

Minimally invasive transpedicular approach for evacuation of epidural abscess and debridement of disc space in a patient with discitis in the thoracic spine

2013 ◽  
Vol 35 (v2supplement) ◽  
pp. Video6
Author(s):  
Lee A. Tan ◽  
Ippei Takagi ◽  
Harel Deutsch
Keyword(s):  
Minimally Invasive ◽  
Anterior Approach ◽  
Epidural Abscess ◽  
Symptomatic Improvement ◽  
Neurological Deficits ◽  
Spinal Epidural Abscess ◽  
Surgical Morbidity ◽  
Disc Space ◽  
Transpedicular Approach ◽  
Spinal Epidural

Spinal epidural abscess (SEA) often requires prompt surgical decompression to prevent potential devastating neurological deficits. Dorsally located SEA usually can be evacuated via simple laminectomies. Ventral SEA often requires an anterior approach such as thoracotomy to achieve adequate exposure and decompression. We report a case of ventral thoracic SEA associated with discitis and osteomyelitis that was successfully treated via minimally invasive transpedicular approach. The patient had immediate and dramatic symptomatic improvement and was ambulatory on post-operative Day 1. The minimally invasive transpedicular approach avoids the surgical morbidity associated with anterior approach and is effective surgical alternative to treat ventral SEA.The video can be found here: http://youtu.be/do-K1VWYhi4.

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