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Epidural Abscess

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https://www.readbyqxmd.com/read/28187806/diagnosis-and-management-of-spinal-cord-emergencies
#1
E P Flanagan, S J Pittock
Most spinal cord injury is seen with trauma. Nontraumatic spinal cord emergencies are discussed in this chapter. These myelopathies are rare but potentially devastating neurologic disorders. In some situations prior comorbidity (e.g., advanced cancer) provides a clue, but in others (e.g., autoimmune myelopathies) it may come with little warning. Neurologic examination helps distinguish spinal cord emergencies from peripheral nervous system emergencies (e.g., Guillain-Barré), although some features overlap...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28163938/evaluating-complications-of-chronic-sinusitis
#2
Phillip Hong, Charles A Pereyra, Uta Guo, Adam Breslin, Laura Melville
Chronic sinusitis is a relatively common diagnosis throughout the US. In patients with an otherwise unremarkable medical history the treatment is typically supportive, requiring only clinical evaluation. We present the case of a 25-year-old male with a history of chronic sinusitis that was brought to our emergency department with new-onset seizure. Three days before he had presented to his usual care facility with two days of headache and fever and was discharged stating headache, subjective fever, and neck stiffness...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28159488/lateral-lumbar-retroperitoneal-transpsoas-approach-in-the-setting-of-spondylodiscitis-a-technical-note
#3
George M Ghobrial, Fadi Al-Saiegh, Daniel Franco, Daniel Benito, Joshua Heller
Thoracolumbar spondylodiscitis is a morbid disease entity, impacting a sick patient population with multiple comorbidities. Wherever possible, surgical measures in this population should limit the extent of soft tissue disruption and overall morbidity that is often associated with anteroposterior thoracolumbar decompression and fusion. The authors describe the rationale, technique, and use of the lateral lumbar transpsoas retroperitoneal approach in tandem with posterior decompression and instrumented fusion in the treatment of circumferential thoracolumbar spondylodiscitis with or without epidural abscesses...
January 31, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28134749/prognostic-factors-for-failure-of-antibiotic-treatment-in-patients-with-osteomyelitis-of-the-spine
#4
Jan Jaap de Graeff, Nuno Rui Paulino Pereira, Olivier D van Wulfften Palthe, Sandra B Nelson, Joseph H Schwab
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: Identify factors independently associated with antibiotic treatment failure in patients with spinal osteomyelitis. SUMMARY OF BACKGROUND DATA: There are few studies that have identified risk factors for antibiotic treatment failure in medically-managed spinal osteomyelitis. Identifying such factors could help to identify patients who can be treated solely with antibiotics. METHODS: All patients who underwent antibiotic treatment for spinal osteomyelitis in one of our institutions between January 1 2001 until January 1 2015 were identified...
January 27, 2017: Spine
https://www.readbyqxmd.com/read/28127138/primary-spinal-epidural-b-lymphoblastic-lymphoma
#5
Rakul K Nambiar, Sreejith G Nair, Pranab K Prabhakaran, Sherin P Mathew
Extranodal lymphomas constitute 20% to 30% of all non-Hodgkin's lymphomas. The common sites involved are skin, stomach, brain, and small intestine. Epidural localization is a rare site for lymphomas, accounting for 10% of spinal epidural tumors. Lymphomas occurring primarily in the epidural space without other previously detected lymphomatous foci (i.e., primary spinal epidural lymphomas) represent an even rarer entity. We report a case of primary spinal epidural B-lymphoblastic lymphoma. The patient presented with paraparesis, and a spinal epidural lesion was diagnosed...
January 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28115866/serratus-anterior-plane-block-for-hybrid-transthoracic-esophagectomy-a-pilot-study
#6
Cinzia Barbera, Pamela Milito, Michele Punturieri, Emanuele Asti, Luigi Bonavina
BACKGROUND: Pain is a major limiting factor in patient's recovery from major thoracic surgical procedures. Thoracic epidural analgesia (TEA), the current gold standard of perioperative management, has contraindications, can technically fail, and carries a risk of complications such as epidural abscess and spinal hematoma. The ultrasound-guided serratus anterior plane (SAP) block is a promising regional analgesia technique. OBJECTIVES: Since the anatomic space involved in the SAP block corresponds to the area exposed by the surgeon during right posterolateral thoracotomy, we investigated the feasibility of a "surgically guided" continuous SAP block as an alternative to TEA in selected esophagectomy patients...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28078834/magnetic-resonance-imaging-findings-of-patients-with-suspected-tuberculosis-from-a-tertiary-care-centre-in-sri-lanka
#7
A S Pallewatte, N A Wickramasinghe
Introduction: Spinal tuberculosis (TB) is a relatively common cause for spinal pathology in Sri Lanka and a common indication for magnetic resonance imaging (MRI). Objectives: The objective of the study was to describe the MRI imaging pattern of spinal TB in a series of patients. Methods: One hundred and nine patients with clinically confirmed spinal tuberculosis who had undergone MRI scans at the National Hospital of Sri Lanka from 2012-2016 were included in the study...
30, 2016: Ceylon Medical Journal
https://www.readbyqxmd.com/read/28068970/quadriplegia-caused-by-an-epidural-abscess-occurring-at-the-same-level-of-cervical-destructive-spondyloarthropathy-a-case-report
#8
Jun-Seok Lee, Ji-Hyun Ryu, Jong-Tae Park, Ki-Won Kim
BACKGROUND: Destructive spondyloarthropathy (DSA) is one of the major complications in patients undergoing long-term hemodialysis. To the best of our knowledge, an epidural abscess occurring at the level of preexisting cervical DSA has not been well described in the literature. We report a unique case of quadriplegia caused by an epidural abscess occurring at the same level of preexisting cervical DSA. CASE PRESENTATION: A 49-year-old woman was transferred to our emergency department with 5 days of sepsis, drowsy mental status, and quadriplegia below the C5 level...
January 10, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28068278/cervical-spondylitis-and-epidural-abscess-caused-by-brucellosis-a-case-report-and-literature-review
#9
Hatice Reşorlu, Suzan Saçar, Beşir Şahin Inceer, Ayla Akbal, Ferhat Gökmen, Coskun Zateri, Yilmaz Savaş
Brucellosis is a zoonotic disease widely seen in endemic regions and that can lead to systemic involvement. The musculoskeletal system is frequently affected, and the disease can exhibit clinical involvements such as arthritis, spondylitis, spondylodiscitis, osteomyelitis, tenosynovitis and bursitis. Spondylitis and spondylodiscitis, common complications of brucellosis, predominantly affect the lumbar and thoracic vertebrae. Epidural abscess may occur as a rare complication of spondylitis. Spinal brucellosis and development of epidural abscess in the cervical region are rare...
December 1, 2016: Folia Medica
https://www.readbyqxmd.com/read/28061487/thermal-induced-osteonecrosis-of-adjacent-vertebra-after-intradiscal-electrothermal-therapy
#10
Soonjoon Kim, Sun-Ho Lee, Eun-Sang Kim, Whan Eoh
A 42-year-old man was admitted to our hospital with complaints of low back pain and intermittent right thigh pain. Twelve weeks before admission, the patient received intradiscal electrothermal therapy (IDET) at a local hospital. The patient still reported low back pain after the procedure that was managed with narcotic analgesics. Follow-up magnetic resonance imaging (MRI) was performed, and his referring physician thought the likely diagnosis was spondylodiscitis at the L4-5 spinal segment with a small epidural abscess...
January 1, 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28053849/long-term-outcome-of-medical-and-surgical-co-management-of-craniospinal-aspergillosis-in-an-immunocompromised-patient
#11
Dipu Sathyapalan, Sabarish Balachandran, Anil Kumar, Bindu Mangalath Rajamma, Ashok Pillai, Vidya P Menon
35 yr old steroid dependent lady with Pulmonary TB underwent debridement of epidural abscess & posterior stabilization for paraparesis. With histopathology and cultures showing Aspergillus fumigatus, voricanozole was started. By the fourth week, she developed persistent fever, and altered mental status. Brain MRI and CSF study including multiplex PCR evaluation confirmed cerebral aspergillosis. Voricanozole was changed to intravenous lipid complex Amphotericin B to achieve sustained clinical and radiological response after six months of therapy...
December 2016: Medical Mycology Case Reports
https://www.readbyqxmd.com/read/28041546/-epidural-abscess-secondary-to-sinusitis
#12
Pernille Henriksen, Noushin Yazdanyar, Lisbeth Samsø Schmidt, Marianne Sjølin Frederiksen
Approximately 0.5-2% of upper viral infections are com-licated by secondary acute bacterial sinusitis and may in rare cases evolve into more serious complications such as meningitis and intracranial abscess. Symptoms are often subtle and nonspecific as fever, headache, scalp tenderness, nausea and altered mental status. In this case report of a 12-year-old boy with an epidural abscess secondary to sinusitis we intend to increase the knowledge to these rare, but potentially life-threatening complications to ensure the optimal and timely treatment...
December 26, 2016: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28038791/combination-therapy-with-vancomycin-and-ceftaroline-for-refractory-methicillin-resistant-staphylococcus-aureus-bacteremia-a-case-series
#13
Diana Gritsenko, Marianna Fedorenko, Jorg J Ruhe, Jerry Altshuler
PURPOSE: Although vancomycin has been the mainstay of therapy for methicillin-resistant Staphylococcus aureus (MRSA) infections, its effectiveness has been challenged. Combination therapy may be used for patients with persistent MRSA bacteremia refractory to initial therapy. Studies have reported in vitro synergy between vancomycin and ceftaroline; however, clinical experience with this therapy is limited. Here, we report our experience with 5 cases of vancomycin-refractory MRSA bacteremia treated with the combination of vancomycin and ceftaroline...
January 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28028447/spinal-epidural-abscess-in-a-patient-with-piriformis-pyomyositis
#14
Gerald S Oh, Hussam Abou-Al-Shaar, Gregory D Arnone, Ashley L Barks, Ziad A Hage, Sergey Neckrysh
BACKGROUND: Spinal epidural abscess resulting from piriformis pyomyositis is extremely rare. Such condition can result in serious morbidity and mortality if not addressed in a timely manner. CASE DESCRIPTION: The authors describe the case of a 19-year-old male presenting with a 2-week history of fever, low back pain, and nuchal rigidity. When found to have radiographic evidence of a right piriformis pyomyositis, he was transferred to our institution for further evaluation...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/28027170/rare-and-serious-complications-of-sinusitis-in-pediatric-patients-epidural-abscess
#15
Recep Sade, Gökhan Polat
Intracranial abscess has serious mortality. Therefore, early diagnosis and treatment is important. Intracranial abscess is rarely seen as a complication of sinusitis. Specially in children it has been reported rarely. Fever and headache can indicate complications in children.
December 23, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28024134/-acute-mastoiditis-with-retroauricular-abscess-a-report-of-two-cases
#16
Andrzej Misiak
Otogenic complications may occur as a result of both acute and chronic otitis media. The purpose of the diagnostic process and treatment of patients with otogenic complications is to identify and eliminate focal points of the infection. Due to general application of antibiotics, these complications are rarely observed. Retroauricular abscess may be the first symptom associated with the development of acute mastoiditis in patients with communication disturbances. Intravenous antibiotics and surgery have been successfully used for treatment in the two described cases...
December 22, 2016: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28018923/spinal-epidural-abscess-in-adults-a-10-year-clinical-experience-at-a-tertiary-care-academic-medical-center
#17
Andrew W Artenstein, Jennifer Friderici, Adam Holers, Deirdre Lewis, Jan Fitzgerald, Paul Visintainer
Background.  Delayed recognition of spinal epidural abscess (SEA) contributes to poor outcomes from this highly morbid and potentially lethal infection. We performed a case-control study in a regional, high-volume, tertiary care, academic medical center over the years 2005-2015 to assess the potential changing epidemiology, clinical and laboratory manifestations, and course of this disorder and to identify factors that might lead to early identification of SEA. Methods.  Diagnostic billing codes consistent with SEA were used to identify inpatient admissions for abstraction...
October 2016: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/27993739/septic-arthritis-of-an-atlantoaxial-facet-joint-with-normal-inflammatory-markers-case-report-and-literature-review
#18
Gokhan Kuyumcu, Claus S Simpfendorfer, Maja Babic, Iain H Kalfas, Lucileia Teixeira-Johnson, Carl S Winalski
BACKGROUND: Septic arthritis of the atlantoaxial facet joint is extremely rare. Contiguous spread to the median atlantoaxial joints with subsequent dens erosion can lead to atlantoaxial instability. Misleading normal inflammatory markers can result in delayed diagnosis and catastrophic consequences. CASE DESCRIPTION: A 56-year-old man presented with right-sided neck pain that had lasted for 2 days. He did not have fever or chills, and his serum C-reactive protein and erythrocyte sedimentation rate were normal...
December 18, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27979742/neurological-deficit-secondary-to-a-pre-sacral-abscess-with-epidural-extension-up-to-l3-a-case-report-and-literature-review
#19
M Khalifé, D Lebeaux, J-L Mainardi, P Guigui, B Bouyer
Isolated epidural abscesses are uncommon lesions. Surgical treatment may be difficult due to the extension of these lesions. We present a case of a pelvic abscess spreading along the path of the sciatic nerve to the gluteus muscles and the lumbar canal, causing neurological compression; requiring surgical treatment with three simultaneous approaches.
December 12, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27965310/rare-cause-of-back-pain-staphylococcus-aureus-vertebral-osteomyelitis-complicated-by-recurrent-epidural-abscess-and-severe-sepsis
#20
Louise Dunphy, Shabnam Iyer, Christopher Brown
An epidural abscess represents a rare acute medical emergency, with a reported incidence of 2.5/10 000 hospital admissions annually. The clinical features include fever, spinal pain, radiating nerve root pain and leg weakness. When sepsis is present, prompt recognition is required to initiate appropriate antimicrobial therapy and surgical decompression. We present the case of a man aged 68 years presenting to the emergency department with a 3-day history of fever, low back, right hip and leg pain. He was hypoxic, tachycardic and hypotensive...
December 13, 2016: BMJ Case Reports
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