scholarly journals Community-Acquired MRSA Pyomyositis: Case Report and Review of the Literature

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Douglas P. Olson ◽  
Sarita Soares ◽  
Sandhya V. Kanade
Keyword(s):  
Epidural Abscess ◽  
Surgical Intervention ◽  
Cauda Equina ◽  
Spinal Epidural Abscess ◽  
Paraspinal Muscles ◽  
Sensory Deficits ◽  
Antibiotic Management ◽  
History Of ◽  
Spinal Epidural ◽  
Repeat Imaging

Community-acquired methicillin-resistantStaphylococcus aureus(CA-MRSA) is responsible for a broad range of infections. We report the case of a 46-year-old gentleman with a history of untreated, uncomplicated Hepatitis C who presented with a 2-month history of back pain and was found to have abscesses in his psoas and right paraspinal muscles with subsequent lumbar spine osteomyelitis. Despite drainage and appropriate antibiotic management the patient's clinical condition deteriorated and he developed new upper extremity weakness and sensory deficits on physical exam. Repeat imaging showed new, severe compression of the spinal cord and cauda equina from C1 to the sacrum by a spinal epidural abscess. After surgical intervention and continued medical therapy, the patient recovered completely. This case illustrates a case of CA-MRSA pyomyositis that progressed to lumbar osteomyelitis and a spinal epidural abscess extending the entire length of the spinal canal.

scholarly journals Just the Facts: Risk stratifying non-traumatic back pain for spinal epidural abscess in the emergency department

CJEM ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. 753-755
Author(s):  
Zoe Polsky ◽  
Shawn K. Dowling ◽  
W. Bradley Jacobs
Keyword(s):  
Emergency Department ◽  
Back Pain ◽  
Epidural Abscess ◽  
Spinal Epidural Abscess ◽  
Thoracic Spinal ◽  
Life Threatening ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Whole Spine ◽  
Spinal Epidural

A 65-year-old male with a history of hypertension presents to the emergency department (ED) with new onset of non-traumatic back pain. The patient is investigated for life-threatening diagnoses and screened for “red flag symptoms,” including fever, neurologic abnormalities, bowel/bladder symptoms, and a history of injectiondrug use (IVDU). The patient is treated symptomatically and discharged home but represents to the ED three additional times, each time with new and progressive symptoms. At the time of admission, he is unable to ambulate, has perineal anesthesia, and 500 cc of urinary retention. Whole spine magnetic resonance imaging (MRI) confirms a thoracic spinal epidural abscess. This case, and many like it, prompts the questions: when should emergency physicians consider the diagnosis of a spinal epidural abscess, and what is the appropriate evaluation of these patients in the ED? (Figure 1).

scholarly journals Community-Acquired Serratia Marcescens Spinal Epidural Abscess in a Patient Without Risk Factors: Case Report and Review

2008 ◽  
Vol 19 (3) ◽  
pp. 250-252 ◽  
Author(s):  
Michael D Parkins ◽  
Daniel B Gregson
Keyword(s):  
Risk Factors ◽  
Case Report ◽  
Serratia Marcescens ◽  
Immune Suppression ◽  
Epidural Abscess ◽  
Cauda Equina ◽  
Invasive Disease ◽  
Spinal Epidural Abscess ◽  
Medical Comorbidities ◽  
Spinal Epidural

Serratia marcescenshas rarely been reported as an agent of invasive disease in patients presenting from the community. Furthermore,S marcescensis frequently opportunistic, affecting individuals with serious medical comorbidities including immune suppression and diabetes. A case of a community-acquiredS marcescensspontaneous lumbar epidural abscess presenting as cauda equina syndrome is reported in a previously well 36-year-old man with no identifiable risk factors. To the authors’ knowledge, this is the first report of invasiveS marcescenscausing disease in a patient with no medical comorbidities.

Aggressive Surgical Intervention in End-Stage Renal Disease Patients with Spinal Epidural Abscess

Renal Failure ◽  
2011 ◽  
Vol 33 (6) ◽  
pp. 582-586 ◽  
Author(s):  
Mei-Yi Wu ◽  
Tsai-Sheng Fu ◽  
Chih-Hsiang Chang ◽  
Hsiang-Hao Hsu ◽  
Ming-Yang Chang ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Epidural Abscess ◽  
Surgical Intervention ◽  
Spinal Epidural Abscess ◽  
Stage Renal Disease ◽  
End Stage ◽  
Spinal Epidural

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 Spinal Epidural Abscess in a Child with Eczema: A Case Report and Literature Review

2012 ◽  
Vol 19 (6) ◽  
pp. 411-416 ◽  
Author(s):  
YP Tsang ◽  
MY Sy ◽  
TW Wong
Keyword(s):  
Computed Tomography ◽  
Epidural Abscess ◽  
Early Recognition ◽  
Emergency Operation ◽  
Neurological Complications ◽  
Uneventful Recovery ◽  
Spinal Epidural Abscess ◽  
History Of ◽  
Spinal Epidural ◽  
Chronic Eczema

Spinal epidural abscess is rare in children. Early recognition is important to prevent or minimise neurological complications. We report a case of paediatric spinal epidural abscess. An 8-year-old girl, with a history of poorly controlled atopic eczema over the back of neck, presented with back pain and subsequently fever and worsening backache. Diagnosis was made only after computed tomography. Emergency operation with drainage of the abscess was done and vancomycin was given for 5 weeks. The patient made an uneventful recovery with no neurological complications. Bacteraemia from skin excoriation due to chronic eczema was the presumed aetiology.

scholarly journals A rare etiology of cauda equina syndrome

2010 ◽  
Vol 5 (01) ◽  
pp. 079-082 ◽  
Author(s):  
Sumit Batra ◽  
Sumit Arora ◽  
Hemant Meshram ◽  
Geetika Khanna ◽  
Shabnam B Grover ◽  
...  
Keyword(s):  
Cauda Equina Syndrome ◽  
English Language ◽  
Medical Literature ◽  
Epidural Abscess ◽  
Fungal Infections ◽  
Cauda Equina ◽  
Immunocompetent Patient ◽  
Spinal Epidural Abscess ◽  
Oral Itraconazole ◽  
Spinal Epidural

Fungal infections of the spine are very rare and usually seen in immunocompromised patients. Acute cauda equina syndrome presenting in an immunocompetent patient is usually due to a prolapse of the intervertebral disc. Infective pathology caused by Mycobacterium tuberculosis with epidural collection can also have a similar presentation. We present a case of spinal epidural abscess caused by Aspergillus fumigatus, presenting as acute cauda equina syndrome. To the best of our knowledge, spinal aspergillosis presenting as cauda equina syndrome in an immunocompetent patient has not been reported before in the English-language based medical literature. Surgical decompression with antifungal treatment with oral itraconazole yielded a good recovery.

scholarly journals Tubercular spinal epidural abscess involving the dorsal-lumbar-sacral region without osseous involvement

2011 ◽  
Vol 5 (07) ◽  
pp. 544-549 ◽  
Author(s):  
Sumit Arora ◽  
Ramesh Kumar
Keyword(s):  
English Language ◽  
Medical Literature ◽  
Epidural Abscess ◽  
Cauda Equina ◽  
Uneventful Recovery ◽  
Spinal Epidural Abscess ◽  
Vertebral Level ◽  
Osseous Involvement ◽  
Vertebral Involvement ◽  
Spinal Epidural

Musculoskeletal tuberculosis is known for its ability to present in various forms and guises at different sites. Tubercular spinal epidural abscess (SEA) is an uncommon infectious entity. Its presence without associated osseous involvement may be considered an extremely rare scenario. We present a rare case of tubercular SEA in an immune-competent 35-year-old male patient. The patient presented with acute cauda equina syndrome and was shown to have multisegmental SEA extending from D5 to S2 vertebral level without any evidence of vertebral involvement on MRI. The patient made an uneventful recovery following surgical decompression and antitubercular chemotherapy. The diagnosis was confirmed by histopathological demonstration of Mycobacterium tuberculosis in drained pus. Such presentation of tubercular SEA has not been reported previously in the English language based medical literature to the best of our knowledge

Spinal Epidural Abscess: A Ten-Year Perspective

Neurosurgery ◽  
1990 ◽  
Vol 27 (2) ◽  
pp. 177-184 ◽  
Author(s):  
Mary Louise Hlavin ◽  
Henry J. Kaminski ◽  
Jeffery S. Ross ◽  
Edward Ganz
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Epidural Abscess ◽  
Surgical Intervention ◽  
Imaging Modality ◽  
Spinal Epidural Abscess ◽  
Resonance Imaging ◽  
Laboratory Findings ◽  
Prognostic Features ◽  
Spinal Epidural

Abstract A retrospective study of spinal epidural abscess spanning 10 years and encompassing 40 patients was done. Epidemiology, clinical features, laboratory findings, radiographic imaging, therapy, and outcome were examined and compared with previous series. An increasing incidence of the disease (up to 1.96 patients per 10,000 admissions per year) and an older, more debilitated population (67% having factors predisposing them to infection) were discovered. Over half of the population was studied with magnetic resonance imaging, which was found to be equally as sensitive (91%) as myelography with computed tomography (92%). Magnetic resonance imaging offers the advantages of being noninvasive and able to delineate other entities, which makes it the imaging modality of choice. Preoperative paralysis and neurological deterioration from normal were identified as poor prognostic features. Of 7 patients with preoperative paralysis, 5 died, and the rest failed to recover neurological function. Eleven patients with initially normal neurological exams deteriorated in the hospital before surgical intervention. Eight of these patients were being treated with appropriate antibiotics; 2 became paralyzed despite more than 3 weeks of antibiotic therapy. Only 3 of these 11 patients recovered fully. Immediate surgical decompression combined with antibiotics remains the treatment of choice.

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