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Epidural Abscess

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https://www.readbyqxmd.com/read/28430048/a-spinal-epidural-abscess-due-to-streptobacillus-moniliformis-infection-following-a-rat-bite-case-report
#1
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
#2
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
#3
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
https://www.readbyqxmd.com/read/28407707/destruction-of-the-c2-body-due-to-cervical-actinomycosis-connection-between-spinal-epidural-abscess-and-retropharyngeal-abscess
#4
Dong Min Kim, Seok Won Kim
Human actinomycosis with involvement of the spine is a rare condition, with only a limited number of case reports published. To the best of our knowledge, no cases have been reported of epidural abscess causing destruction of the C2 body, bringing about a direct connection between spinal epidural and retropharyngeal abscesses. Here, we present such a case that occurred after acupuncture, and we review the relevant literature.
March 2017: Korean Journal of Spine
https://www.readbyqxmd.com/read/28407706/gas-containing-cervical-epidural-abscess-accompanying-bacterial-meningitis-in-an-adult
#5
Dong Min Kim, Seok Won Kim
Gas-containing spinal epidural abscesses are uncommon. Moreover, acute spinal epidural abscesses rarely complicate bacterial meningitis in adults. Here, we report a rare case of a gas-containing cervical epidural abscess accompanying bacterial meningitis. In spite of aggressive fluid and continuous antibiotic therapy after the isolation of Streptococcus anginosus and Streptococcus constellatus in the cerebrospinal fluid cultures, the patient showed remaining motor dysfunction and bladder involvement. Our experience suggests that the effort to prevent neurologic deterioration by emergent surgical decompression and drainage of pus is mandatory to avoid additional spinal cord dysfunction in patients with spinal epidural abscesses accompanying bacterial meningitis...
March 2017: Korean Journal of Spine
https://www.readbyqxmd.com/read/28405074/pott-puffy-tumor
#6
Pranav Sharma, Salil Sharma, Nishant Gupta, Puneet Kochar, Yogesh Kumar
Pott puffy tumor is osteomyelitis of the frontal bone with associated subperiosteal abscess causing swelling and edema over the forehead and scalp. It is a complication of frontal sinusitis or trauma. We present the case of an 8-year-old girl with frontal swelling. Imaging evaluation showed frontal osteomyelitis as a complication of frontal sinusitis with associated epidural and subperiosteal abscess. The patient was treated surgically and recovered well. This case highlights the need for high clinical suspicion and early diagnosis and management to prevent life-threatening complications...
April 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28399828/discography-aids-definitive-diagnosis-of-posterior-epidural-migration-of-lumbar-disc-fragments-case-report-and-literature-review
#7
Morito Takano, Tomohiro Hikata, Soraya Nishimura, Michihiro Kamata
BACKGROUND: Posterior epidural migration of lumbar disc fragments (PEMLDF) is extremely rare. It is often confused with other posterior lesions and is usually diagnosed intraoperatively. We here describe the use of preoperative discography in the diagnosis of PEMLDF. CASE PRESENTATION: A 78-year-old man presented with acute low back pain, gait disturbance, and paresthesia in both legs. Magnetic resonance imaging showed a mass located posteriorly and laterally to the left aspect of the dural sac at the L3 level...
April 11, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28399057/staphylococcus-aureus-central-nervous-system-infections-in-children
#8
Jesus G Vallejo, Alexandra N Cain, Edward O Mason, Sheldon L Kaplan, Kristina G Hultén
BACKGROUND: Central nervous system (CNS) infections due to Staphylococcus aureus are uncommon in pediatric patients. We review the epidemiology, clinical features, and treatment in 68 patients with a S. aureus CNS infection evaluated at Texas Children's Hospital (TCH). METHODS: Cases of CNS infection in children with positive cerebrospinal fluid cultures or spinal epidural abscess for S. aureus at TCH from 2001-2013 were reviewed. RESULTS: 70 cases of S...
April 10, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28379730/paraspinal-edema-is-the-most-sensitive-feature-of-lumbar-spinal-epidural-abscess-on-unenhanced-mri
#9
Anna Shifrin, Qin Lu, Michael H Lev, Timothy M Meehan, Ranliang Hu
OBJECTIVE: Spinal epidural abscess (SEA) is a serious infection requiring prompt treatment and potential neurosurgical intervention. Although contrast-enhanced spine MRI is the mainstay for diagnosis of SEA, unenhanced MRI is typically performed for patients with nonspecific symptoms or insufficient clinical information. We evaluated the sensitivity and specificity of imaging features suggestive of SEA at unenhanced spine MRI. MATERIALS AND METHODS: We searched our database for contrast-enhanced lumbar spine MRI examinations from January 1, 2000, through August 1, 2014, with "epidural abscess" in the report...
April 5, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28377250/acute-spinal-epidural-hematoma-after-acupuncture-personal-case-and-literature-review
#10
Maurizio Domenicucci, Daniele Marruzzo, Alessandro Pesce, Antonino Raco, Paolo Missori
BACKGROUND: Spinal acupuncture is a relatively safe and common analgesic treatment, but it may be complicated by serious adverse effects such as direct spinal cord and nerve root injury, subdural empyema and epidural abscesses. In this report we are comparing our case of an extremely uncommon spinal epidural hematoma which appeared following treatment by acupuncture with other similar documented cases. CASE DESCRIPTION: This is the case of a 64-year-old man who presented a left hemiparesis associated with paraesthesias...
April 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28366427/errors-in-diagnosis-of-spinal-epidural-abscesses-in-the-era-of-electronic-health-records
#11
Viraj Bhise, Ashley N D Meyer, Hardeep Singh, Li Wei, Elise Russo, Aymer Al-Mutairi, Daniel R Murphy
PURPOSE: To identify missed opportunities in diagnosis of spinal epidural abscesses to outline areas for process improvement. METHODS: Using a large national clinical data repository, we identified all patients with a new diagnosis of spinal epidural abscess in the Department of Veterans Affairs (VA) during 2013. Two physicians independently conducted retrospective chart reviews on 250 randomly selected patients and evaluated their records for red flags (e.g., unexplained weight loss, neurological deficits, and fever) 90 days prior to diagnosis...
March 30, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28337426/pathogen-identification-in-suspected-cases-of-pyogenic-spondylodiscitis
#12
Ahmad Farajzadeh Sheikh, Azar D Khosravi, Hamed Goodarzi, Roohangiz Nashibi, Alireaza Teimouri, Azim Motamedfar, Reza Ranjbar, Sara Afzalzadeh, Mehrandokht Cyrus, Mohammad Hashemzadeh
Pyogenic spinal infection continues to represent a worldwide problem. In approximately one-third of patients with pyogenic spondylodiscitis, the infectious agent is never identified. Of the cases that lead to organismal identification, bacteria are more commonly isolated from the spine rather than fungi and parasites. This study applied universal prokaryotic 16S rRNA PCR as a rapid diagnostic tool for the detection of bacterial agents in specimens from patients suspected of pyogenic spondylodiscitis. Gram and Ziehl-Neelsen staining were used as a preliminary screening measure for microbiologic evaluation of patient samples...
2017: Frontiers in Cellular and Infection Microbiology
https://www.readbyqxmd.com/read/28327980/frontal-sinus-breach-during-routine-frontal-craniotomy-significantly-increases-risk-of-surgical-site-infection-10-year-retrospective-analysis
#13
Joseph R Linzey, Thomas J Wilson, Stephen E Sullivan, B Gregory Thompson, Aditya S Pandey
BACKGROUND: Frontotemporal craniotomies are commonly performed for a variety of neurosurgical pathologies. Infections related to craniotomies cause significant morbidity. We hypothesized that the risk of cranial surgical site infections (SSIs) may be increased in patients whose frontal sinuses are breached during craniotomy. OBJECTIVE: To compare the rate of cranial SSIs in patients undergoing frontotemporal craniotomies with and without frontal sinus breach (FSB)...
March 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28324216/new-classification-for-the-treatment-of-pyogenic-spondylodiscitis-validation-study-on-a-population-of-250-patients-with-a-follow-up-of-2%C3%A2-years
#14
Enrico Pola, G Autore, V M Formica, V Pambianco, D Colangelo, R Cauda, M Fantoni
PURPOSE: Pyogenic spondylodiscitis (PS) is still burdened by a high rate of orthopedic and neurological complications. Despite the rising incidence, the choice of a proper orthopedic treatment is often delayed by the lack of clinical data. The aim of this study was to propose a clinical-radiological classification of pyogenic spondylodiscitis to define a standard treatment algorithm. METHODS: Based on data from 250 patients treated from 2008 to 2015, a clinical-radiological classification of pyogenic spondylodiscitis was developed...
March 21, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28319551/a-contemporary-medicolegal-analysis-of-implanted-devices-for-chronic-pain-management
#15
Christopher R Abrecht, Penny Greenberg, Ellen Song, Richard D Urman, James P Rathmell
BACKGROUND: Analysis of closed malpractice claims allows the study of rare but serious complications and likely results in improved patient safety by raising awareness of such complications. Clinical studies and closed claims analyses have previously reported on the common complications associated with intrathecal drug delivery systems (IDDS) and spinal cord stimulators (SCS). This study provides a contemporary analysis of claims from within the past 10 years. METHODS: We performed a closed claims analysis for a period January 1, 2009 to December 31, 2013 for cases with pain medicine as the primary service...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28284111/characteristics-and-predictors-of-outcome-of-spontaneous-spinal-epidural-abscesses-treated-conservatively-a-retrospective-cohort-study-in-a-referral-center
#16
Nikolaos Spernovasilis, Stelios Demetriou, Maria Bachlitzanaki, Ioannis Gialamas, Kalliopi Alpantaki, Georgios Hamilos, Apostolos Karantanas, Achilleas Gikas
OBJECTIVE: Recent studies have shown that in carefully selected patients, conservative treatment alone can be an option in the management of spinal epidural abscess (SEA). The aim of this study was to identify prognostic factors of outcome in patients with spontaneous SEA treated conservatively. PATIENTS AND METHODS: A retrospective cohort study of all patients with spontaneous SEA treated with antibiotics alone from January 2012 to December 2015 was conducted in a 1200-bed tertiary referral center...
February 27, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28260769/morbidity-and-mortality-after-pancreatoduodenectomy-a-five-year-experience-in-bangabandhu-sheikh-mujib-medical-university
#17
B C Das, A S Khan, N E Elahi, M S Uddin, B C Debnath, Z R Khan
Mortality and morbidity was assessed after adoption of a systematic care for patient with pancreatoduodenectomy starting from patient selection and preparation, operative technique, and postoperative care. In this prospective study seventy patients who underwent pancreatoduodenectomy for periampullary carcinoma with curative intent between January 2010 and December 2014 were carefully analyzed prospectively. Patients were selected those who had ampullary carcinoma, lower bile duct carcinoma and small size carcinoma head of pancreas without local invasion and distant metastasis, and the patient who did not have any major disabling comorbid diseases...
January 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28253945/-pyogenic-spinal-infections-in-adults-a-5-year-experience-from-a-tertiary-care-centre
#18
O Džupová, R Cihlářová
PURPOSE OF THE STUDY To describe epidemiological and clinical features of pyogenic spinal infections in patients treated at the Department of Infectious, Parasitic and Tropical Diseases of the Hospital Na Bulovce in 2010-2014, and to analyse a predictive significance of selected variables. MATERIAL AND METHODS A single-centre retrospective cohort study carried out from 1.1.2010 to 31.12.2014 enrolled adult patients with septic spondylitis, discitis and facet joint infections. Recorded parameters included: demographics, chronic comorbidities, time to diagnosis, radiological work-up, anatomical level of spinal infection, source of infection, etiological agent, complications, treatment and outcomes...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28250635/the-role-of-minimally-invasive-spine-surgery-in-the-management-of-pyogenic-spinal-discitis
#19
Mazda K Turel, Mena Kerolus, Harel Deutsch
BACKGROUND: Diagnostic yields for spondylodiscitis from CT guided biopsy is low. In the recent years, minimally invasive surgery (MIS) has shown to have a low morbidity and faster recovery. For spinal infections, MIS surgery may offer an opportunity for early pain control while obtaining a higher diagnostic yield than CT-guided biopsies. The aim of this study was to review our patients who underwent MIS surgery for spinal infection and report outcomes. METHODS: A retrospective review of seven patients who underwent MIS decompression and/or discectomy in the setting of discitis, osteomyelitis, spondylodiscitis, and/or an epidural abscess was identified...
January 2017: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/28249310/diagnostic-yield-of-multidetector-computed-tomography-in-patients-with-acute-spondylodiscitis
#20
Vanessa Hanna Rausch, Peter Bannas, Gerhard Schoen, Andreas Froelich, Lennart Well, Marc Regier, Gerhard Adam, Frank Oliver Gerhard Henes
Purpose To determine the value of multidetector computed tomography (MDCT) in patients with acute spondylodiscitis. Methods and Materials For data acquisition, we searched our radiological database for all patients who had undergone magnetic resonance imaging (MRI) for suspected spondylodiscitis between 2007 and 2015 (n = 325). For further analyses, we included all patients (n = 67) who initially underwent MDCT prior to MRI. Overall accuracy, sensitivity, specificity and positive and negative predictive values were calculated for MDCT and, separately, for contrast-enhanced CT (CECT, n = 36) and for non-enhanced CT (NECT, n = 31)...
April 2017: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
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