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Epidural Abscess

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https://www.readbyqxmd.com/read/28648472/oesophageal-pleural-fistula-presenting-with-parvimonas-micra-infection-causing-cervical-and-brain-abscesses
#1
REVIEW
Anan Shtaya, Helmut Schuster, Peter Riley, Kathryn Harris, Samantha Hettige
Parvimonas micra (P. micra) infections causing spinal cord compression are extremely rare. We report an occult oesophageal pleural fistula presenting with spinal epidural and brain abscesses resulting in severe neurological deficits caused by P. micra. Molecular detection proved to be instrumental in identifying the causative pathogen. Essential management with decompression, drainage, antibiotics and fistula repair lead to a good outcome.
June 22, 2017: Anaerobe
https://www.readbyqxmd.com/read/28637119/disco-vertebral-osteomyelitis-causing-intradural-spinal-abscess-with-cauda-equina-compression
#2
Anan Shtaya, Samantha Hettige
Intradural extramedullary spinal infections causing cauda equina compression are uncommon. We report an Escherichia coli bacteraemia causing lumbar discitis and an intracanalicular collection compressing the cauda equina: initially thought to be an epidural empyema, however microsurgery revealed an intradural location. Decompression, drainage, antibiotics, and neuropathy treatment are essential management.
March 3, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28608178/minimally-invasive-spine-surgery-in-lumbar-spondylodiscitis-a-retrospective-single-center-analysis-of-67-cases
#3
Anja Tschugg, Sebastian Hartmann, Sara Lener, Andreas Rietzler, Neururer Sabrina, Claudius Thomé
BACKGROUND: Minimally invasive surgical techniques have been developed to minimize tissue damage, reduce narcotic requirements, decrease blood loss, and, therefore, potentially avoid prolonged immobilization. Thus, the purpose of the present retrospective study was to assess the safety and efficacy of a minimally invasive posterior approach with transforaminal lumbar interbody debridement and fusion plus pedicle screw fixation in lumbar spondylodiscitis in comparison to an open surgical approach...
June 12, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28583099/magnetic-resonance-imaging-of-bacterial-and-tuberculous-spondylodiscitis-with-associated-complications-and-non-infectious-spinal-pathology-mimicking-infections-a-pictorial-review
#4
REVIEW
Yogesh Kumar, Nishant Gupta, Avneesh Chhabra, Takeshi Fukuda, Neetu Soni, Daichi Hayashi
Magnetic resonance (MR) imaging plays an important role in the evaluation of bacterial and tuberculous spondylodiscitis and associated complications. Owing to its high sensitivity and specificity, it is a powerful diagnostic tool in the early diagnosis of ongoing infections, and thus provides help in prompt initiation of appropriate, therapy which may be medical or surgical, by defining the extent of involvement and detection of complications such as epidural and paraspinal abscesses. More specifically, MR imaging helps in differentiating bacterial from tuberculous infections and enables follow up of progression or resolution after appropriate treatment...
June 5, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28562520/langerhans-cell-histiocytosis-mimicking-a-pott-puffy-tumor
#5
Luca Pasquini, Maria Camilla Rossi Espagnet, Giacomo Esposito, Rita De Vito, Raffaella Messina, Stefania Gaspari, Daniela Longo
Langherans' cell histiocytosis (LCH) is a rare disease mostly affecting children in the first decade of life. As clinical presentation is extremely heterogenous, a prompt diagnosis may be challenging, sometimes leading to a diagnostic delay, especially when the disease involves a single site. Herein, we report a case of a child with an unusual presentation of (LCH) mimicking a Pott puffy tumor with extracranial and epidural abscesses, surgically treated. Through this unique case we summarize possible manifestations of LCH with bone involvement and we underline the importance of considering possible complications due to bone erosions such as infection, to avoid a misdiagnosis...
May 29, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28541433/a-cervical-epidural-abscess-after-the-racz-procedure-in-a-patient-with-failed-cervical-surgery-syndrome
#6
Serbülent Gökhan Beyaz, Fatih Sahin, Ali Eman
No abstract text is available yet for this article.
May 24, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28538361/characteristics-of-and-risk-factors-for-severe-neurological-deficit-in-patients-with-pyogenic-vertebral-osteomyelitis-a-case-control-study
#7
RANDOMIZED CONTROLLED TRIAL
Adrien Lemaignen, Idir Ghout, Aurélien Dinh, Guillaume Gras, Bruno Fantin, Virginie Zarrouk, Robert Carlier, Jean-Edouard Loret, Eric Denes, Alix Greder, François-Xavier Lescure, David Boutoille, Pierre Tattevin, Bertrand Issartel, Jean-Philippe Cottier, Louis Bernard
Severe neurological deficit (SND) is a rare but major complication of pyogenic vertebral osteomyelitis (PVO). We aimed to determine the risk factors and the variables associated with clinical improvement for SND during PVO.This case-control study included patients without PVO-associated SND enrolled in a prospective randomized antibiotic duration study, and patients with PVO-associated SND managed in 8 French referral centers. Risk factors for SND were determined by logistic regression.Ninety-seven patients with PVO-associated SND cases, and 297 controls were included...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28533868/-rare-medico-surgical-emergency-spinal-epidural-abscess-about-3-cases
#8
Abderrazzak El Saqui, Mohamed Aggouri, Mohamed Benzagmout, Khalid Chakour, Mohamed El Faiz Chaoui
The awareness about infections in the epidural space is increasing thanks to the development of neurosurgery, including MRI. Spinal epidural abscess is a rare pathology but extremely serious from a functional point of view and potentially life threatening. We report three cases of male patients (the first one aged 52 years, the second 57 years and the third 63 years) with diagnosed spinal epidural abscess. Two patients were admitted to the Neurosurgical Emergencies with slow progressive spinal cord compression evolving in the context of infection...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28532175/patient-presenting-with-frontal-subperiosteal-abscess-and-headache-a-case-of-pott-s-puffy-tumour
#9
Hakan Şimşek
Chronic sinusitis can be complicated with erosion of anterior or posterior wall of the sinus; causing Pott's puffy tumour in the anterior, or epidural abscess in the posterior communication. A 65-year old man with a painful swelling in his forehead is presented. Pott's puffy tumour was diagnosed. CT, MRI, and DTI studies were obtained. Epidural or dural involvement was not present. In the first operation, anterior wall of the frontal sinus wall was opened. Osteomyelitis debridement was performed and the frontonasal duct was enlarged endoscopically...
May 22, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28524751/pseudogout-of-the-cervical-and-thoracic-spine-mimicking-infection-after-lumbar-fusion-case-report
#10
Kelly J Bridges, Carli L Bullis, Ajay Wanchu, Khoi D Than
Pseudogout is a form of acute calcium pyrophosphate deposition (CPPD) disease that typically afflicts the elderly. CPPD commonly involves larger joints, such as the knees, wrists, shoulders, and hips, and has been known to involve the spine. The authors report the case of a 66-year-old woman with a recent history of lumbar laminectomy and fusion who presented 5 weeks postprocedure with a clinical and radiographic picture consistent with multilevel skip lesions involving the cervical and thoracic spine, thoracic discitis, and epidural abscess...
May 19, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28504498/-pediatric-case-report-spinal-epidural-abscess
#11
Mauricio Pons, Leila Pérez, Facundo Juárez
Spinal epidural abscess is an uncommon pathology. It has an incidence of one case per 100 000 individuals. An increase is observed due to the raise of risk factors such as diabetes mellitus, spinal abnormalities, tattoos, acupuncture, epidural analgesia, and a greater availability of imaging methods. It is a purulent collection located between the dura and the medullary canal. The most common germs are Staphylococcus aureus and Gram-negative bacteria. Without timely treatment, it evolves to medullary compression and permanent neurological sequelae...
June 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28498071/assessment-of-malpractice-claims-due-to-spinal-epidural-abscess
#12
J Mason DePasse, Roy Ruttiman, Adam E M Eltorai, Mark A Palumbo, Alan H Daniels
OBJECTIVE Spinal epidural abscesses (SEAs) can be difficult to diagnose and may result in neurological compromise or even death. Delays in diagnosis or treatment may worsen the prognosis. While SEA presents a high risk for litigation, little is known about the medicolegal ramifications of this condition. An enhanced understanding of potential legal implications is important for practicing spine surgeons, emergency medicine physicians, and internists. METHODS The VerdictSearch database, a large legal-claims database, was queried for "epidural abscess"-related legal cases...
May 12, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28492440/diskitis-osteomyelitis-spinal-epidural-abscess-meningitis-and-endocarditis-following-sacroiliac-joint-injection-for-the-treatment-of-low-back-pain-in-a-patient-on-therapy-for-hepatitis-c-virus
#13
Geeta Nagpal, John P Flaherty, Honorio T Benzon
OBJECTIVE: Sacroiliac joint injections are frequently performed procedures in the management of acute and chronic low-back pain, including patients with various immunocompromised states. Infectious complications following these procedures along with other spinal injections are rarely reported, but the true incidence is unknown. The purpose of this report is to highlight the devastating neurologic sequela that can occur, and to discuss potential future management strategies. CASE REPORT: We present a patient who developed diskitis, osteomyelitis, spinal epidural abscess, meningitis, and endocarditis from Staphylococcus aureus, all of which developed shortly after a sacroiliac joint injection...
July 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28482336/spinal-subdural-abscess-following-repeat-lumbar-microdiscectomy-a-case-report-of-imaging-findings-for-a-rare-infection
#14
Shao Z Chen, Adam L Shimer, Nicholas C Nacey
Spinal subdural abscess is a rare central nervous system infection with just over a hundred cases reported. It is much less common than spinal epidural abscess. While most case reports have focused on route of infection and treatment options, there have not been any reports that focused on the unique MRI findings of spinal subdural abscess. We describe a case of spinal subdural abscess diagnosed by MRI in a 33-year-old male who presented with headaches after undergoing a microdiscectomy procedure, and review the underlying anatomic features of the spinal meninges which produce the appearance of a spinal subdural abscess...
April 27, 2017: Clinical Imaging
https://www.readbyqxmd.com/read/28457929/cervical-spondylodiscitis-presentation-timing-and-surgical-management-in-59-patients
#15
George M Ghobrial, Daniel Franco, Thana Theofanis, Philip J Margiotta, Edward Andrews, Jefferson Wilson, James S Harrop, Joshua E Heller
BACKGROUND: Cervical spondylodiscitis is thought to carry a significant risk for rapid neurologic deterioration with a poor response to nonsurgical management. METHODS: A retrospective surgical case series of the acute surgical management of cervical spondylodiscitis is reviewed to characterize the neurologic presentation and postoperative neurologic course in a relatively uncommon disease. RESULTS: 59 patients were identified (mean age 59 yrs, range 18-83yrs, SD ±13...
April 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28443599/a-pott-s-puffy-tumor-associated-with-epidural-cutaneous-fistula-and-epidural-abscess-case-report
#16
Aleksandar Perić, Milanko Milojević, Dražen Ivetić
BACKGROUND: Pott's puffy tumour is characterized by a fluctuate swelling of the frontal region as a result of osteomyelitis of the frontal bone. This inflammatory lesion may propagate endocranially, resulting in acute meningitis, epidural abscess, subdural empyema, cavernous sinus trombophlebitis, cerebritis, and frontal lobe abscess of the brain. CASE REPORT: We present an unusual case of a 33-year-old man suffering from Pott's puffy tumour whose condition was further complicated by a draining epidural-cutaneous fistula and an epidural abscess...
May 5, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/28435744/diagnosis-of-spinal-epidural-abscess-a-case-report-and-literature-review
#17
Chidinma Chima-Melton, Michelle Pearl, Marni Scheiner
INTRODUCTION: Spinal epidural abscess (SEA) is a rare but serious cause of back pain in the critical care setting. It occurs most commonly in adults in their fifth and sixth decades of life. Risk factors include diabetes mellitus, alcoholism, AIDS or other immunocompromised states, cancer, intravenous drug use, trauma and spinal surgery. The clinical presentation can be non-specific but the classical triad includes back pain, fever and neurological deficits. Magnetic resonance imaging (MRI) with gadolinium is the diagnostic imaging modality of choice...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28430048/a-spinal-epidural-abscess-due-to-streptobacillus-moniliformis-infection-following-a-rat-bite-case-report
#18
Alexander Hammer, Dorit Wolff, Walter Geißdörfer, Michael Schrey, Renate Ziegler, Hans-Herbert Steiner, Christian Bogdan
The authors describe the case of a 40-year-old man suffering from an epidural abscess in the thoracic spine due to a rarely isolated pathogen, Streptobacillus moniliformis, the causative agent of rat bite fever. Besides diffuse abdominal pain, ataxia, paresthesia, hypesthesia, and enhanced reflexes of the lower extremities, the patient suffered from a decreased sensation of bladder filling. His history was also positive for a rat bite 6 weeks earlier. Magnetic resonance imaging showed an epidural, space-occupying lesion compressing the spinal cord at the vertebral levels of T6-8...
April 21, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28417614/spinal-epidural-abscess-caused-by-brucella-species-a-review-of-17-cases
#19
Qin Zhang, Xiaohui Yang, Honglin Yu, Benrang Jia, Bin Meng
BACKGROUND: Spinal epidural abscess (SEA) is a rarely encountered clinical entity during the course of Brucella infection. METHODS: We reported 17 patients diagnosed with Brucellar SEA for a mean follow-up of 15 months. Spinal epidural abscess was detected by magnetic resonance imaging in all cases. Brucella diagnosis was established by serological tests. Patients were administered antibiotics for duration of 6 to 16 weeks. RESULTS: SEA was localized in lumbar region in 9 patients, thoracic in 4 patients, cervical in 3 patients, both thoracic and lumbar in 1 patient...
June 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/28417063/melanized-fungus-as-an-epidural-abscess-a-diagnostic-and-therapeutic-challenge
#20
Adesh Shrivastava, Karuna Tadepalli, Garima Goel, Kajal Gupta, Pradeep Kumar Gupta
Curvularia a dematiaceous fungus is ubiquitously found in soil around the world. We report an epidural abscess due to Curvularia lunata in a 48 years male farmer who underwent decompressive laminectomy as primary modality of treatment followed by isolation, identification and confirmation of the isolate from tissue by ITS sequencing. Antifungal therapy with voriconazole and amphotericin B for 3 and 2 weeks respectively improved patient's condition and is presently on regular follow up with no sequelae since last 7 months...
June 2017: Medical Mycology Case Reports
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