Open AccessSpinal Epidural Abcess
Author(s) -
Douglas Serra Vasconcelos,
Lucas Crociati Meguins,
Domingos Edno Castro Ribeiro,
Giselle da Silva Mello,
Dicla Caroline Hartuique Rodrigues,
Victor Hugo Toyoki Motoki Teixeira,
Juvenal de Souza Rogério
Publication year - 2018
Publication title -
jornal brasileiro de neurocirurgia
Language(s) - English
Resource type - Journals
eISSN - 2446-6786
pISSN - 0103-5118
DOI - 10.22290/jbnc.v21i1.809
Subject(s) - medicine , epidural abscess , surgery , paraplegia , abscess , paresis , magnetic resonance imaging , decompression , urinary retention , back pain , anesthesia , spinal cord , radiology , alternative medicine , pathology , psychiatry
Spinal epidural abscess (SEA) is an extremely rare life-threatening infectious disorder. It accounts for 0.2-2.0/10,000 hospital admissions per year. We report on a young man with a recent history of furunculosis that evolved febrile back pain associated with triparesia with right upper extremity paresis and crural paraplegia. He referred also symptoms of urinary incontinency. Magnetic resonance imaging (MRI) of the thoracolumbar spine showed an epidural mass compressing two thoracic vertebras, from T4 to T5. The patient underwenturgent surgical decompression of the epidural abscess and culture of the purulent collection grew Methicillin-sensitive Staphylococcus aureus. Postoperative combined intravenous antibiotic treatment was instituted with metronidazole, oxacilin and gentamicin during 30 days. The patient had anuneventful recovery without any residual neurologic deficits. This report highlights the importance of an early suspicion of SEA in patients with febrile back pain and initial neurologic deficits with known risk factors for epidural abscess. Aggressive treatment with surgical decompression and systemicantibiotics seems to be an appropriate approach to prevent permanent neurologic deficits.