scholarly journals Community-Acquired MRSA Pyomyositis: Case Report and Review of the Literature

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Douglas P. Olson ◽  
Sarita Soares ◽  
Sandhya V. Kanade

Community-acquired methicillin-resistantStaphylococcus aureus(CA-MRSA) is responsible for a broad range of infections. We report the case of a 46-year-old gentleman with a history of untreated, uncomplicated Hepatitis C who presented with a 2-month history of back pain and was found to have abscesses in his psoas and right paraspinal muscles with subsequent lumbar spine osteomyelitis. Despite drainage and appropriate antibiotic management the patient's clinical condition deteriorated and he developed new upper extremity weakness and sensory deficits on physical exam. Repeat imaging showed new, severe compression of the spinal cord and cauda equina from C1 to the sacrum by a spinal epidural abscess. After surgical intervention and continued medical therapy, the patient recovered completely. This case illustrates a case of CA-MRSA pyomyositis that progressed to lumbar osteomyelitis and a spinal epidural abscess extending the entire length of the spinal canal.

CJEM ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. 753-755
Author(s):  
Zoe Polsky ◽  
Shawn K. Dowling ◽  
W. Bradley Jacobs

A 65-year-old male with a history of hypertension presents to the emergency department (ED) with new onset of non-traumatic back pain. The patient is investigated for life-threatening diagnoses and screened for “red flag symptoms,” including fever, neurologic abnormalities, bowel/bladder symptoms, and a history of injectiondrug use (IVDU). The patient is treated symptomatically and discharged home but represents to the ED three additional times, each time with new and progressive symptoms. At the time of admission, he is unable to ambulate, has perineal anesthesia, and 500 cc of urinary retention. Whole spine magnetic resonance imaging (MRI) confirms a thoracic spinal epidural abscess. This case, and many like it, prompts the questions: when should emergency physicians consider the diagnosis of a spinal epidural abscess, and what is the appropriate evaluation of these patients in the ED? (Figure 1).


2008 ◽  
Vol 19 (3) ◽  
pp. 250-252 ◽  
Author(s):  
Michael D Parkins ◽  
Daniel B Gregson

Serratia marcescenshas rarely been reported as an agent of invasive disease in patients presenting from the community. Furthermore,S marcescensis frequently opportunistic, affecting individuals with serious medical comorbidities including immune suppression and diabetes. A case of a community-acquiredS marcescensspontaneous lumbar epidural abscess presenting as cauda equina syndrome is reported in a previously well 36-year-old man with no identifiable risk factors. To the authors’ knowledge, this is the first report of invasiveS marcescenscausing disease in a patient with no medical comorbidities.


Renal Failure ◽  
2011 ◽  
Vol 33 (6) ◽  
pp. 582-586 ◽  
Author(s):  
Mei-Yi Wu ◽  
Tsai-Sheng Fu ◽  
Chih-Hsiang Chang ◽  
Hsiang-Hao Hsu ◽  
Ming-Yang Chang ◽  
...  

Author(s):  
Meryem Badem ◽  
Serpil Ugur Baysal ◽  
İlknur Karyağdı ◽  
Nusret Oren ◽  
Hamit Selim Karabekir ◽  
...  

Spinal infections in immunocompetent children are very rare. But it is a serious infection in the epidural space along the spinal cord. It should be considered in patients with backache, fever, neurological deficits and/or spinal tenderness. There are cases which an etiology could not determined. In the English medical literature, there are only 31 reported pediatric cases in the last two decades. In children with neurologic deficits, surgery combined with systemic antibiotics constitutes the optimal therapy. We report a case of thoracal spinal epidural abscess in a 12-year-old adolescent boy who was immunocompetent and presented with spinal tenderness, back pain and four days of fever. A spinal magnetic resonance imaging demonstrated an epidural abscess between T2 and T10 level. An emergent surgical intervention was applied. Cultures remained negative. He was given systemic antibiotics for six weeks. He recovered without any sequelae.


2012 ◽  
Vol 19 (6) ◽  
pp. 411-416 ◽  
Author(s):  
YP Tsang ◽  
MY Sy ◽  
TW Wong

Spinal epidural abscess is rare in children. Early recognition is important to prevent or minimise neurological complications. We report a case of paediatric spinal epidural abscess. An 8-year-old girl, with a history of poorly controlled atopic eczema over the back of neck, presented with back pain and subsequently fever and worsening backache. Diagnosis was made only after computed tomography. Emergency operation with drainage of the abscess was done and vancomycin was given for 5 weeks. The patient made an uneventful recovery with no neurological complications. Bacteraemia from skin excoriation due to chronic eczema was the presumed aetiology.


2011 ◽  
Vol 5 (07) ◽  
pp. 544-549 ◽  
Author(s):  
Sumit Arora ◽  
Ramesh Kumar

Musculoskeletal tuberculosis is known for its ability to present in various forms and guises at different sites. Tubercular spinal epidural abscess (SEA) is an uncommon infectious entity. Its presence without associated osseous involvement may be considered an extremely rare scenario. We present a rare case of tubercular SEA in an immune-competent 35-year-old male patient. The patient presented with acute cauda equina syndrome and was shown to have multisegmental SEA extending from D5 to S2 vertebral level without any evidence of vertebral involvement on MRI. The patient made an uneventful recovery following surgical decompression and antitubercular chemotherapy. The diagnosis was confirmed by histopathological demonstration of Mycobacterium tuberculosis in drained pus. Such presentation of tubercular SEA has not been reported previously in the English language based medical literature to the best of our knowledge


2010 ◽  
Vol 5 (01) ◽  
pp. 079-082 ◽  
Author(s):  
Sumit Batra ◽  
Sumit Arora ◽  
Hemant Meshram ◽  
Geetika Khanna ◽  
Shabnam B Grover ◽  
...  

Fungal infections of the spine are very rare and usually seen in immunocompromised patients. Acute cauda equina syndrome presenting in an immunocompetent patient is usually due to a prolapse of the intervertebral disc. Infective pathology caused by Mycobacterium tuberculosis with epidural collection can also have a similar presentation. We present a case of spinal epidural abscess caused by Aspergillus fumigatus, presenting as acute cauda equina syndrome. To the best of our knowledge, spinal aspergillosis presenting as cauda equina syndrome in an immunocompetent patient has not been reported before in the English-language based medical literature. Surgical decompression with antifungal treatment with oral itraconazole yielded a good recovery.


2019 ◽  
Vol 5 (2) ◽  
pp. 46-49
Author(s):  
Sanjay Kumar ◽  

Spinal tuberculosis has a significant disease burden in India and presents with a myriad of features on neuroimaging. Spinal epidural abscess (SEA) is relatively rare diagnosis. Long segment SEA is a possibility in patients with spinal tuberculosis and these patients will respond to conservative’s management with ATT unlike pyogenic SEA which frequently may require early surgical intervention


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