PubMed · 6001784
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N N Nadzhmitdinov, V E Klevits. 1966. [Bone abscesses].. https://pubmed.ncbi.nlm.nih.gov/6001784/
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STUDY DESIGN: This case report illustrates the need to be aware of extraspinal causes of sciatica. A patient with a strangulated sciatic hernia showed the clinical features of sciatic leg pain, intestinal obstruction, and a left gluteal abscess. OBJECTIVE: To highlight the need to examine the course of the sciatic nerve for local pathology when the cause of sciatica is not obvious. SUMMARY OF BACKGROUND DATA: Sciatic herniae are rare. The coexistence of sciatica and a gluteal abscess, caused by a strangulated sciatic hernia, does not appear to have been reported previously. METHODS: A 66-year-old woman with preexisting low back pain and left leg pain was admitted to the hospital with intestinal obstruction and a left gluteal mass. Results of needle aspiration suggested the diagnosis, which was confirmed by laparotomy. The sciatic hernia was repaired via a transabdominal approach. RESULTS: The symptoms of sciatic nerve compression and intestinal obstruction resolved fully after surgery. CONCLUSION: The possibility of local pathology causing sciatic nerve compression should be considered when a patient reports sciatic leg pain, particularly if the presentation is atypical. Intestinal obstruction or the presence of a gluteal mass should suggest the possibility of a sciatic hernia.
AIMS: To review the clinical presentation and outcome of patients with spinal epidural abscess. METHODS: Following an index case, additional cases were identified during 1991-6. RESULTS: There were a total of seven patients with spinal epidural abscess and an average age of 52 years (range 24-75 years). The abscess locations were cervical (3), thoracic (3) or thoracolumbar (1), and extended on average 4.3 vertebral bodies (range 2-9). Staphylococcus aureus was the aetiologic agent in all of the six microbiologically confirmed cases. Three abscesses arose from adjacent vertebral osteomyelitis, one followed epidural anaesthesia and two arose by haematogenous spread. New spinal or radicular pain were the most frequent early symptoms, later, nerve root weakness or a sensory level. An ESR > 30 mm/hour was consistently present but fever and leukocytosis were absent in some patients. MRI (five cases) and myelography (one case) were diagnostic. Five patients underwent laminectomy and abscess drainage; in three, limb weakness improved markedly post operatively. Three of the four patients with paralysis died, two despite laminectomy. CONCLUSIONS: New spinal pain, radicular symptoms or signs, and a raised ESR were the most consistent early abnormalities in patients with a spinal epidural abscess. Diagnosis at an early clinical stage was associated with a better outcome.
Acute suppurative infection of salivary glands in the neonatal period is a rare entity; and almost always involves the parotid glands. A rare case of neck abscess in association with right submandibular suppurative sialadenitis in a 7-day-old baby is presented. The possible etiology, diagnosis, and management of this uncommon disease are discussed.