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Epidural Abscess

Sanka Amadoru, Kwang Lim, Mark Tacey, Craig Aboltins
AIMS: To explore differences in presentation and outcomes between younger and older patients with bacterial spinal infections. METHODS: Clinical, microbiological and radiological information was collected for patients at a single metropolitan hospital with spinal infections (spondylodiscitis, vertebral osteomyelitis, septic discitis, facet joint septic arthritis, and spinal epidural abscess) between January 2008 and January 2015. Patients were excluded if under 18 years of age, or if clinical and imaging findings were inconsistent with the diagnosis...
October 18, 2016: Internal Medicine Journal
Rachel Desai, Ursula Dickson, Desiderio Rodrigues, Karl-Christian Thies
No abstract text is available yet for this article.
November 2016: European Journal of Anaesthesiology
Elisa Kupersztych-Hagege, Etienne Dubuisson, Barbara Szekely, Mireille Michel-Cherqui, Jean François Dreyfus, Marc Fischler, Morgan Le Guen
OBJECTIVE: To report the major complications (epidural hematoma and abscess) of postoperative thoracic epidural analgesia in patients who underwent lung surgery. DESIGN: Prospective, monocentric study. SETTING: A university hospital. PARTICIPANTS: All lung surgical patients who received postoperative thoracic epidural analgesia between November 2007 and November 2015. INTERVENTIONS: Thoracic epidural analgesia for patients who underwent lung surgery...
July 18, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Anais Arbault, Paul Ornetti, Romaric Loffroy, Olivier Chevallier, Julien Avril, Pierre Pottecher
We report the case of a parascapular abscess revealing primary tuberculosis of the posterior arch in a 31-year-old man. Sectional imaging is essential in order to detect the different lesions of this atypical spinal tuberculosis as osteolysis of the posterior arch extendible to vertebral body, osteocondensation, epidural extension which is common in this location, and high specificity of a zygapophysial, costo-vertebral or transverse arthritis.
August 2016: Quantitative Imaging in Medicine and Surgery
Abdurrahman Aycan, Ozgür Yusuf Aktas, Feyza Karagoz Guzey, Azmi Tufan, Cihan Isler, Nur Aycan, İsmail Gulsen, Harun Arslan
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...
2016: Case Reports in Infectious Diseases
Mi Jeoung Kim, Hyang Mo Koo, Woo Joo Lee, Jin Hwan Choi, Mi Nyong Choi, Sang Young Park, Woo Jung Kim, Seung Yeon Son
Diagnoses of pyelonephritis caused by Staphylococcus aureus should be accompanied by investigations of concomitant bladder obstruction and metastatic infections, especially to the spine or heart. Complicated pyelonephritis due to S. aureus requires more than 2 weeks of antibiotics, which is the typically recommended treatment duration for pyelonephritis. We describe a patient who was diagnosed with complicated epidural and paraspinal abscesses after insufficient evaluation and treatment of acute pyelonephritis due to S...
September 2016: Korean Journal of Family Medicine
David Dornbos, Jocelyn Morin, Joshua R Watson, Jonathan Pindrik
Osteomyelitis of the spine with associated spinal epidural abscess represents an uncommon entity in the pediatric population, requiring prompt evaluation and diagnosis to prevent neurological compromise. Cat scratch disease, caused by the pathogen Bartonella henselae, encompasses a wide spectrum of clinical presentations; however, an association with osteomyelitis and epidural abscess has been reported in only 4 other instances in the literature. The authors report a rare case of multifocal thoracic osteomyelitis with an epidural abscess in a patient with a biopsy-proven pathogen of cat scratch disease...
September 23, 2016: Journal of Neurosurgery. Pediatrics
Alexandra Stratton, Karla Gustafson, Kenneth Thomas, Matthew T James
OBJECTIVE Spinal epidural abscess (SEA) is a life-threatening infection. It is uncertain whether medical versus surgical treatment is the ideal initial approach for neurologically intact patients with SEA. Recent evidence demonstrates that initial medical management is increasingly common; however, patients who ultimately require surgery after failed medical management may have a worse prognosis than those whose treatment was initially surgical. The primary objective of this study was to establish the current incidence of failed medical management for SEA...
September 16, 2016: Journal of Neurosurgery. Spine
Masayuki Oki, Akihiro Ueda, Ayumi Tsuda, Hidetaka Yanagi, Hideki Ozawa, Atsushi Takagi
Infection with non-typhoidal Salmonella often results in a self-limited acute gastroenteritis. Extra-intestinal Salmonella infection is relatively rare and occurs predominantly in infants and adults with significant underlying conditions. We describe a 54-year-old Japanese man with a history of heavy alcohol consumption and daily contact with a dog, who developed bacteremia complicated by vertebral osteomyelitis, spinal epidural abscess, and meningitis, due to Salmonella enterica serotype Enteritidis. This case suggests that Salmonella should be considered as an etiologic pathogen in adult patients with perivertebral infection or meningitis...
2016: Tokai Journal of Experimental and Clinical Medicine
Tamara M Johnson, Chandrika Chitturi, Michael Lange, Jin S Suh, Jihad Slim
Streptococcus pneumoniae vertebral infections have rarely been reported. Herein, we report a case of pneumococcal vertebral osteomyelitis with paraspinal and epidural abscesses as well as concomitant bacteremia following epidural injection. This will be the second case in the literature reporting pneumococcal vertebral osteomyelitis related to epidural manipulation.
July 2016: Journal of Global Infectious Diseases
Ian David Kaye, Themistocles S Protopsaltis
Pyogenic cervical facet joint infections are rare and such infections from a dental origin are even less common. Of these few cases, none have described infection with Streptococcus intermedius as the pathogen. A 65-year-old orthopaedic surgeon complained of fevers, right-sided radiating neck pain, stiffness, swelling, erythema, and right upper extremity weakness one month after he had broken a crown over his right mandibular premolar, a continued source of pain. Imaging of the cervical spine showed a right C4-C5 facet inflammatory arthropathy and a small epidural abscess that was cultured and initially treated with intravenous antibiotics...
September 2016: Bulletin of the Hospital for Joint Diseases
Sina Pourtaheri, Kimona Issa, Tyler Stewart, Yashika Patel, Kumar Sinha, Ki Hwang, Arash Emami
BACKGROUND: How the relative volume of an epidural abscess on MRI affects outcomes with antibiotics alone has limited literature. The purpose of this study was to identify which infected epidural collections will reabsorb with antibiotics alone. Specifically, what is the critical size and enhancement on contrast MRIs to require a drainage procedure? MATERIALS AND METHODS: A retrospective review of all spinal osteomyelitis patients from 2001-2012 was performed. Inclusion criteria included appropriate initial imaging, lab results, no drainage procedures of collections, and no treatment prior to admission at an outside institution...
September 10, 2016: Surgical Technology International
Przemysław Kunert, Marek Prokopienko, Arkadiusz Nowak, Tomasz Czernicki, Andrzej Marchel
BACKGROUND: Spinal epidural abscesses (SEAs) in cervical locations are particularly life-threatening. Currently, SEAs are widely treated with bony decompression, followed by internal stabilization in purulent osteomyelitis. However, recently, a growing number of studies have reported minimally invasive approaches without internal fixation. PURPOSE: We describe four patients with cervical SEAs that were evacuated by oblique corpectomy (OC) without fusion. METHODS: This study included two women and two men (aged 44-90) that received operations for removing ventral cervical SEAs...
August 24, 2016: Neurologia i Neurochirurgia Polska
Florent Espitalier, Anne de Keating-Hart, Sylvain Morinière, Jean-Michel Badet, Nathalie Asseray, Christophe Ferron, Olivier Malard
PURPOSE: To highlight cervical spondylodiscitis as an infrequent complication following an invasive procedure on the neopharynx in patients previously treated with circumferential pharyngolaryngectomy with pectoralis major myocutaneous flap reconstruction. METHODS: Patients diagnosed with cervical spondylodiscitis after circumferential pharyngolaryngectomy between 2001 and 2013 were retrospectively studied using a questionnaire sent to the French head and neck tumour study group...
August 26, 2016: European Spine Journal
Zhongheng Zhang, Xiao Xu, Hongying Ni
We here presented a 65-year-old woman with disseminated Staphylococcus aureus infection following spinal anesthesia. The patient underwent spinal anesthesia for great saphenous vein stripping. Twenty days after the procedure, the patient developed hydrocephalus, pulmonary infection, and epidural abscess. Microbiological culture of the pus showed infection by S aureus. Appropriate antibiotic therapy and prompt surgical abscess drainage were associated with good outcome. Hydrocephalus is thought to be associated with arachnoiditis caused by S aureus infection, which provides new insights into the pathophysiology of arachnoiditis...
September 2016: Journal of Clinical Anesthesia
Mai Murata, Katsuhiro Yoshikawa, Munehisa Hiratsuka, Shigehiko Suzuki
We herein report a 62-year-old man with an extensive sacral decubitus ulcer complicated by an epidural abscess. An epidural abscess is a rare disease, but it should be considered in the differential diagnosis of a deep infection with decubitus. Moreover, the diagnosis may be late in such instances and should be carefully considered when a patient has paralysis.
July 2016: Plastic and Reconstructive Surgery. Global Open
Cecilia Martín-Gandul, M J Mayorga-Buiza, E Castillo-Ojeda, M J Gómez-Gómez, M Rivero-Garvía, M V Gil-Navarro, F J Márquez-Rivas, M E Jiménez-Mejías
BACKGROUND: Evidence for the effectiveness of linezolid in neurosurgical infections (NSIs) is growing. The comfortable oral dosage and tolerance of linezolid opens the possibility for sequential antimicrobial treatment (SAT) in stable patients after a period of intravenous treatment. METHODS: To evaluate the efficacy and safety of SAT with oral linezolid in patients with NSI and to analyse the cost implications, an observational, non-comparative, prospective cohort study was conducted on clinically stable consecutive adult patients at the Neurosurgical Service...
October 2016: Acta Neurochirurgica
Ehab Shiban, Insa Janssen, Pedro Ribeiro da Cunha, Jessica Rainer, Michael Stoffel, Jens Lehmberg, Florian Ringel, Bernhard Meyer
BACKGROUND: To date, there is growing consensus that PEEK material may be used for interbody fusion in spinal infections. Data supporting that claim are however restricted to a few very small clinical series. The aim of this study is to evaluate the outcome of surgical treatment of pyogenic spinal infections with PEEK cages in combination with posterior pedicel screw fixation. METHODS: Between 2006 and 2013, a total of 211 patients suffering from spondylodiscitis underwent surgical debridement and instrumentation...
October 2016: Acta Neurochirurgica
Huadong Yang, Kedong Hou, Lin Zhang, Xifeng Zhang, Yan Wang, Peng Huang, Songhua Xiao
The aim of this study was to evaluate the efficacy of minimally invasive spinal decompression combined with local chemotherapy in treating patients with thoracic/lumbar tuberculosis (TB) and abscess compression of the spinal canal. Clinical data of 31 patients with thoracic/lumbar TB and spinal epidural abscess, admitted to our hospital between December 2005 and June 2014 were retrospectively analyzed. All patients received initial conservative treatment but achieved unsatisfactory results and then underwent minimally invasive spinal canal decompression, focus debridement and catheter drainage through a posterior interlaminar approach...
October 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Jing Jing Chan, Jen Jen Oh
BACKGROUND: Acupuncture is a form of traditional Chinese medicine being increasingly used as complementary therapy in many countries. It is relatively safe and rarely associated with deep infections. CASE PRESENTATION: In this case report, we describe a middle-aged Chinese patient who presented acutely to our emergency department with cauda equina syndrome secondary to acupuncture-related epidural abscesses, which were treated with surgical decompression and intravenous antibiotics...
December 2016: International Journal of Emergency Medicine
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