scholarly journals Spinal Epidural Abscess in Hemodialysis Patients: A Case Series and Review

2011 ◽  
Vol 6 (6) ◽  
pp. 1495-1500 ◽  
Author(s):  
San S. Wong ◽  
Smitha Daka ◽  
Andrew Pastewski ◽  
Win Kyaw ◽  
Edward Chapnick ◽  
...  
Keyword(s):  
Epidural Abscess ◽  
Case Series ◽  
Hemodialysis Patients ◽  
Spinal Epidural Abscess ◽  
Spinal Epidural

Two Cases of Spinal Epidural Abscess in Hemodialysis Patients

2013 ◽  
Vol 30 (1) ◽  
pp. 36
Author(s):  
Young Hwan Kim ◽  
Jin Taek Yoo ◽  
Soon Myung Jung ◽  
Sang Chang Kwon ◽  
Seung Min Ryu ◽  
...  
Keyword(s):  
Epidural Abscess ◽  
Hemodialysis Patients ◽  
Spinal Epidural Abscess ◽  
Spinal Epidural

scholarly journals Management of cervical spine epidural abscess: a systematic review

2019 ◽  
Vol 6 ◽  
pp. 204993611986394
Author(s):  
Anastasia Turner ◽  
Linlu Zhao ◽  
Paul Gauthier ◽  
Suzan Chen ◽  
Darren M. Roffey ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Medical Management ◽  
Epidural Abscess ◽  
Treatment Options ◽  
Spinal Column ◽  
Case Series ◽  
Spinal Epidural Abscess ◽  
Optimal Method ◽  
Initial Surgery ◽  
Spinal Epidural

Background: Cervical spinal epidural abscess (CSEA) is a localized infection between the thecal sac and cervical spinal column which may result in neurological deficit and death if inadequately treated. Two treatment options exist: medical management and surgical intervention. Our objective was to analyze CSEA patient outcomes in order to determine the optimal method of treatment. Methods: An electronic literature search for relevant case series and retrospective reviews was conducted through June 2016. Data abstraction and study quality assessment were performed by two independent reviewers. A lack of available data led to a post hoc decision not to perform meta-analysis of the results; study findings were synthesized qualitatively. Results: 927 studies were identified, of which 11 were included. Four studies were ranked as good quality, and seven ranked as fair quality. In total, data from 173 patients were included. Mean age was 55 years; 61.3% were male. Intravenous drug use was the most common risk factor for CSEA development. Staphylococcus aureus was the most commonly cultured pathogen. 140 patients underwent initial surgery, an additional 18 patients were surgically treated upon failure of medical management, and 15 patients were treated with antibiotics alone. Conclusion: The rates of medical management failure described in our review were much higher than those reported in the literature for thoracolumbar spinal epidural abscess patients, suggesting that CSEA patients may be at a greater risk for poor outcomes following nonoperative treatment. Thus, early surgery appears most viable for optimizing CSEA patient outcomes. Further research is needed in order to corroborate these recommendations.

Fungal spinal epidural abscess: a case series of nine patients

2019 ◽  
Vol 19 (3) ◽  
pp. 516-522 ◽  
Author(s):  
Huiliang Yang ◽  
Akash A. Shah ◽  
Sandra B. Nelson ◽  
Joseph H. Schwab
Keyword(s):  
Epidural Abscess ◽  
Case Series ◽  
Spinal Epidural Abscess ◽  
Spinal Epidural

scholarly journals The indications and timing for operative management of spinal epidural abscess: literature review and treatment algorithm

2014 ◽  
Vol 37 (2) ◽  
pp. E8 ◽  
Author(s):  
Alexander Tuchman ◽  
Martin Pham ◽  
Patrick C. Hsieh
Keyword(s):  
Literature Review ◽  
Medical Management ◽  
Epidural Abscess ◽  
Nonoperative Management ◽  
Treatment Algorithm ◽  
Case Series ◽  
Spinal Epidural Abscess ◽  
Pubmed Database ◽  
Cord Injury ◽  
Spinal Epidural

Object Delayed or inappropriate treatment of spinal epidural abscess (SEA) can lead to serious morbidity or death. It is a rare event with significant variation in its causes, anatomical locations, and rate of progression. Traditionally the treatment of choice has involved emergency surgical evacuation and a prolonged course of antibiotics tailored to the offending pathogen. Recent publications have advocated antibiotic treatment without surgical decompression in select patient populations. Clearly defining those patients who can be safely treated in this manner remains in evolution. The authors review the current literature concerning the treatment and outcome of SEA to make recommendations concerning what population can be safely triaged to nonoperative management and the optimal timing of surgery. Methods A PubMed database search was performed using a combination of search terms and Medical Subject Headings, to identify clinical studies reporting on the treatment and outcome of SEA. Results The literature review revealed 28 original case series containing at least 30 patients and reporting on treatment and outcome. All cohorts were deemed Class III evidence, and in all but two the data were obtained retrospectively. Based on the conclusions of these studies along with selected smaller studies and review articles, the authors present an evidence-based algorithm for selecting patients who may be safe candidates for nonoperative management. Conclusions Patients who are unable to undergo an operation, have a complete spinal cord injury more than 48 hours with low clinical or radiographic concern for an ascending lesion, or who are neurologically stable and lack risk factors for failure of medical management may be initially treated with antibiotics alone and close clinical monitoring. If initial medical management is to be undertaken the patient should be made aware that delayed neurological deterioration may not fully resolve even after prompt surgical treatment. Patients deemed good surgical candidates should receive their operation as soon as possible because the rate of clinical deterioration with SEA is notoriously unpredictable. Although patients tend to recover from neurological deficits after treatment of SEA, the time point when a neurological injury becomes irreversible is unknown, supporting emergency surgery in those patients with acute findings.

Aggregatibacter aphrophilus spinal epidural abscess

2020 ◽  
Vol 13 (7) ◽  
pp. e235320
Author(s):  
Antoine Altdorfer ◽  
Pierre Gavage ◽  
Filip Moerman
Keyword(s):  
Risk Factors ◽  
Lower Limb ◽  
Rare Case ◽  
Epidural Abscess ◽  
Spinal Epidural Abscess ◽  
Surgical Drainage ◽  
Eikenella Corrodens ◽  
Aggregatibacter Aphrophilus ◽  
Progressive Neurological Deficit ◽  
Spinal Epidural

A 76-year-old woman with a rare case of spinal epidural abscess (SEA) that had no risk factors for such type of infection, presented symptoms of back pain, progressive neurological deficit of the lower limb and loss of sphincter control. A gadolinium-enhanced MRI confirmed the diagnosis of an SEA. The patient underwent laminectomy with surgical drainage, where cultures showed the presence of Aggregatibacter aphrophilus, a bacterium of the HACEK group (Haemophilus species, Aggregatibacter species, Cardiobacterium hominis, Eikenella corrodens, and Kingella species), rarely involved in SEA. Following surgery, the patient was treated with intravenous ceftriaxone for 6 weeks, and this gave excellent results.

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.

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