scholarly journals Spinal epidural abscess: a rare complication of olecranon bursitis

2009 ◽  
Vol 1 (1) ◽  
pp. 1 ◽  
Author(s):  
Rhys D.R. Evans ◽  
Moe Thaya ◽  
Ne Siang Chew ◽  
Charles E.R. Gibbons
Keyword(s):  
Back Pain ◽  
Epidural Abscess ◽  
Rare Complication ◽  
Complete Recovery ◽  
Acute Onset ◽  
Spinal Epidural Abscess ◽  
Good Resolution ◽  
Olecranon Bursitis ◽  
Magnetic Resonance Imaging Mri ◽  
Spinal Epidural

Spinal epidural abscess is a rare but potentially fatal condition if left untreated. We report the case of a 67-year old man who presented to the Accident and Emergency department complaining of acute onset of inter-scapular back pain, left leg weakness and loss of sensation in the left foot. On examination he was found to be pyrexial with long tract signs in the left lower leg. In addition he had a left sided olecranon bursitis of three weeks duration. Blood tests revealed raised inflammatory markers and a staphylococcal bacteremia. Magnetic resonance imaging (MRI) confirmed the diagnosis of spinal epidural abscess and he subsequently underwent a three level laminectomy with good resolution of his back pain and neurological symptoms. He has made a complete recovery with a prolonged course of intravenous antibiotics.

scholarly journals Just the Facts: Risk stratifying non-traumatic back pain for spinal epidural abscess in the emergency department

CJEM ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. 753-755
Author(s):  
Zoe Polsky ◽  
Shawn K. Dowling ◽  
W. Bradley Jacobs
Keyword(s):  
Emergency Department ◽  
Back Pain ◽  
Epidural Abscess ◽  
Spinal Epidural Abscess ◽  
Thoracic Spinal ◽  
Life Threatening ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Whole Spine ◽  
Spinal Epidural

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).

scholarly journals Spinal Epidural Abcess

2018 ◽  
Vol 21 (1) ◽  
pp. 60-63
Author(s):  
Douglas Serra Vasconcelos ◽  
Lucas Crociati Meguins ◽  
Domingos Edno Castro Ribeiro ◽  
Giselle Da Silva Mello ◽  
Dicla Caroline Hartuique Rodrigues ◽  
...  
Keyword(s):  
Back Pain ◽  
Hospital Admissions ◽  
Epidural Abscess ◽  
Thoracolumbar Spine ◽  
Surgical Decompression ◽  
Spinal Epidural Abscess ◽  
Neurologic Deficits ◽  
Life Threatening ◽  
Magnetic Resonance Imaging Mri ◽  
Spinal Epidural

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.

scholarly journals Spinal epidural abscess: a rare complication of olecranon bursitis

2009 ◽  
Vol 1 (1) ◽  
Author(s):  
Charles E.R. Gibbons ◽  
Rhys D.R. Evans ◽  
Moe Thaya ◽  
Ne Siang Chew
Keyword(s):  
Epidural Abscess ◽  
Rare Complication ◽  
Spinal Epidural Abscess ◽  
Olecranon Bursitis ◽  
Spinal Epidural

scholarly journals Ventral holocord spinal epidural abscess managed surgically in a critical setting

2019 ◽  
Vol 10 ◽  
pp. 248
Author(s):  
Sam Supreeth ◽  
Khalifa Al Ghafri
Keyword(s):  
Epidural Abscess ◽  
Complete Recovery ◽  
Acute Onset ◽  
Spinal Epidural Abscess ◽  
Laboratory Studies ◽  
High Grade Fever ◽  
Magnetic Resonance Scan ◽  
History Of ◽  
Spinal Epidural

Background: Extensive epidural abscess is an uncommon entity which is increasing in the aging population. Its prevalence is also greater among those with diabetes mellitus and in those who are immunocompromised. Here, a 59-year-old female presented with a spinal epidural abscess (SEA) warranting operative intervention. Case Description: A 59-year-old female with a history of diabetes and hypertension, presented with the acute onset of a high-grade fever, generalized back pain, and an evolving quadriparesis. Preliminary laboratory studies revealed elevated inflammatory markers. The magnetic resonance scan showed a ventral epidural abscess extending from C1-2 to the L5 level. She underwent urgent surgical decompression using a Nelaton catheter placed through an L4-L5 hemilaminectomy and threaded cephalad (40 cm); this resulted in a complete recovery. Conclusion: This case study underscores a unique way of managing an anterior holospinal SEA extending from the C1-2 through the L5 spinal levels.

scholarly journals Rapidly Progressive Spontaneous Spinal Epidural Abscess

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Abdurrahman Aycan ◽  
Ozgür Yusuf Aktas ◽  
Feyza Karagoz Guzey ◽  
Azmi Tufan ◽  
Cihan Isler ◽  
...  
Keyword(s):  
Epidural Abscess ◽  
Delayed Diagnosis ◽  
Clinical Findings ◽  
Neurological Deficits ◽  
Spinal Epidural Abscess ◽  
Low Back ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Paraspinal Abscess ◽  
Spinal Epidural

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. Treatment of SEA often consists of both medical and surgical therapy including drainage with percutaneous entry, corpectomy, and instrumentation.

Brain Abscess and Spinal Epidural Abscess

2019 ◽  
pp. 642-648
Author(s):  
Selby G. Chen
Keyword(s):  
Magnetic Resonance Imaging ◽  
Brain Abscess ◽  
Hospital Admissions ◽  
Epidural Abscess ◽  
Spinal Epidural Abscess ◽  
Early Management ◽  
Brain Abscesses ◽  
Magnetic Resonance Imaging Mri ◽  
Spinal Epidural ◽  
The Brain

Two infections of the brain are relatively common. Patients with brain abscess are often critically ill and have a high mortality rate. The reported incidence of brain abscesses ranges from 0.4 to 0.9 per 100,000 people. In contrast, spinal epidural abscess (SEA), an infection of the epidural space, has increased in incidence from approximately 0.2 to 1.2 per 10,000 hospital admissions in the mid-1970s to a currently estimated 2.0 to 12.5 per 10,000 admissions. Both disorders are now more easily detected with magnetic resonance imaging (MRI), and this has improved early management, but clinical recognition is still a challenge for many physicians.

scholarly journals Spinal epidural abscess: a rare complication of ulcerative colitis after ileal pouch anal anastomosis

2016 ◽  
Vol 2 (1) ◽  
Author(s):  
Mikio Kawamura ◽  
Toshimitsu Araki ◽  
Yoshiki Okita ◽  
Satoru Kondo ◽  
Takashi Ichikawa ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Ileal Pouch ◽  
Epidural Abscess ◽  
Rare Complication ◽  
Ileal Pouch Anal Anastomosis ◽  
Spinal Epidural Abscess ◽  
Anal Anastomosis ◽  
Spinal Epidural

scholarly journals Recurrence of spinal epidural abscess after inadequate antibiotic dosage regimen

2019 ◽  
Vol 1 (1) ◽  
pp. 66-69
Author(s):  
Ram Krishna Dahal ◽  
Javad Ahmad Khan ◽  
Binod Bijukachhe
Keyword(s):  
Back Pain ◽  
Neurological Deficit ◽  
Epidural Abscess ◽  
Blood Parameters ◽  
Surgical Decompression ◽  
Clinical Suspicion ◽  
Spinal Epidural Abscess ◽  
Threatening Condition ◽  
Clinical Triad ◽  
Spinal Epidural

Introduction: Spinal epidural abscess (SEA) is a potentially life threatening condition which can present with a clinical triad of fever, back pain and neurological deficit. It is more common in elderly population with risk factors like immunocompromised status, diabetes mellitus and alcoholism. High index of clinical suspicion of SEA warrants prompt investigated and treatment. Immediate surgical decompression along with antibiotic is recommended for better outcome. Case Presentation : A 16 years old boy presented with complaints of fever, upper back pain which had developed gradually over a period of 10 days. He had history of furuncle in perineal region 3 weeks prior to his symptoms, which was drained. With high clinical suspicion of SEA, Contrast enhanced Magnetic Resonance Imaging (CEMRI) was done along with blood parameters and was diagnosed as SEA D3-D6 level. He underwent immediate surgical decompression and was given 3 weeks of antibiotics. Post-operative period was uneventful with clinical improvement of the symptoms. He again presented to us with relapse of the infection on 28th post-operative day with similar fever and back pain. He was reinvestigated with MRI and blood investigations which revealed relapse of the infection. He was then managed with intravenous (IV) Vancomycin for 2 weeks and oral Erythromycin for another 6 weeks. He did not require any surgical intervention in his later presentation. Conclusion: Spinal epidural abscess is a surgical emergency and prompt diagnosis with surgical drainage is recommended for better outcome even when there is no neurological deficit. Abscess drainage should be adjunct with longer duration of antibiotics for at least 6 weeks for optimum results.

scholarly journals Cervical, Thoracic, and Lumbar Spine Epidural Abscess: Case Report and Literature Review

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Bohdan Baralo ◽  
Mrunal Kulkarni ◽  
Rithikaa Ellangovan ◽  
Robert Selko ◽  
Ajinkya Kulkarni ◽  
...  
Keyword(s):  
Back Pain ◽  
Epidural Abscess ◽  
Significant Risk ◽  
Needle Aspiration ◽  
Outpatient Setting ◽  
Spinal Epidural Abscess ◽  
Lumbar Region ◽  
Ct Guided ◽  
Low Incidence ◽  
Spinal Epidural

We report a case of a spinal epidural abscess (SEA) in a patient without significant risk factors. The patient was treated in an outpatient setting for one week for worsening back pain and subsequently admitted to the hospital for the treatment of sepsis and suspected SEA. An MRI obtained on admission showed an epidural abscess extending from the lower cervical to the upper lumbar region and accompanying paraspinal cervical and psoas abscesses. The patient was successfully treated with antibiotics based on the sensitivity of the surgical cultures received from a needle aspiration of the abscess. SEA has a low incidence; however, the number of cases is consistently rising over the last two decades. The outcome of SEA treatment is related to the duration of the process prior to intuition of the treatment. Patients with no neurological symptoms, or with symptoms lasting less than 36 h, have the best recovery rate. As the typical symptoms of SEA are seen in only 13% of cases, physicians should have a low threshold to order MRI in patients with back pain that is new or changed from the baseline. With the help of CT-guided aspiration for culture analysis, patients can be successfully treated conservatively using antibiotics in cases where neurological signs are absent.

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