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At least 397 records · Page 22Linked to original sources
PubMed1987

Chronic granulomatous disease with cranial fungal osteomyelitis and epidural abscess. Case report.

A patient is described with osteomyelitis of the cranium and epidural abscess due to Aspergillus fumigatus as the presenting manifestations of chronic granulomatous disease. The diagnosis was suggested by the unusual nature of the organism isolated and confirmed by appropriate laboratory studies. The details of diagnostic assessment and therapeutic management are discussed, and the central nervous system manifestations of chronic granulomatous disease are reviewed.

Brain Abscess↗
PubMed2004

Presacral neuroenteric fistula in a newborn presenting with an epidural abscess: case report and review of the literature.

We describe a newborn infant (<24 hours of age) who presented with mild swelling on the back and buttocks attributable to a neuroenteric fistula complicated by an epidural parasacral abscess infected with mixed coliforms. Epidural abscesses in infancy are extremely rare, and one has not been observed previously in the newborn period. The infant was surprisingly mildly affected. Prompt intervention led to an excellent outcome. Coliforms may colonize the infant gut in <24 hours, even in the developed world. Unexplained swellings on the backs of infants should lead to a search for underlying malformations and an early surgical review, which is best conducted with a combined pediatric surgical and neurosurgical approach.

Enterococcus↗
PubMed2003

Spinal epidural abscess: a diagnostic challenge.

The objective of the study was to highlight the diagnostic challenge of this elusive rare disease. A retrospective study of non-tuberculous spinal epidural abscesses (SEA) was carried out in Southern General Hospital, Glasgow, University Hospital of Wales, Cardiff, and Morriston Hospital, Swansea, from 1990 to 2000. Thirty-nine patients, consisting of 20 females and 19 males, with an age range from 20 to 85 years (mean: 61.1) were identified. Thirty-eight had localized back/neck pain. Eighteen were apyrexial. Twenty-nine demonstrated neurological deficit. All patients had raised inflammatory markers and gadolinium-enhanced magnetic resonance imaging (MRI) was diagnostic in 34. The most commonly identified organism was Staphylococcus aureus. All underwent surgical decompression, of which 13 required stabilization. Three died, seven lacked sphincter control and nine had motor deficit at the end of 1 year. It was concluded that fever is not mandatory for the diagnosis of SEA. Patients with localized back/neck pain and raised inflammatory markers need urgent MRI.

Adult↗
PubMed1994

Spinal epidural abscess caused by Brucella: case report.

We report a case of a patient with symptoms and signs of sciatica, due to spinal epidural abscess caused by Brucella, which was diagnosed by Magnetic Resonance Image. The literature is reviewed and the radiological features, particularly magnetic resonance image findings, are analyzed.

Abscess↗
PubMed2003

Macrolide-resistant pneumococcal endocarditis and epidural abscess that develop during erythromycin therapy.

Suppurative complications of Streptococcus pneumoniae infections have become uncommon in the antibiotic era. We report a case of pneumococcal bacteremia and pneumonia complicated with epidural abscess and endocarditis in which macrolide resistance (the MLS(B) phenotype) emerged during erythromycin therapy. Genetic determinants known to mediate the most common mechanisms of macrolide resistance (methylation of the 23S rRNA and antibiotic efflux) were not detected by polymerase chain reaction or DNA hybridization. Sequence analysis of the DNA encoding the 23S rRNA of the macrolide-resistant isolate from the patient demonstrated the replacement of adenine by thymine at position 2058 (A2058T) in 2 of 4 alleles. Clinicians should be alert to the possibility of the emergence of resistance during macrolide therapy for community-acquired pneumonia, particularly if suppurative complications of pneumococcal infection are suspected.

Anti-Bacterial Agents↗
PubMed2004

Epidural abscess and osteomyelitis due to Actinobacillus actinomycetemcomitans.

Actinobacillus actinomycetemcomitans is a microaerophilic, fastidious Gram-negative rod that most commonly causes periodontitis and odontogenic infections. We report the first case of an epidural abscess and osteomyelitis due to this organism resulting from self-extraction of carious teeth. The patient responded to surgical debridement and prolonged antimicrobial therapy with intravenous ceftriaxone.

Actinobacillus Infections↗
PubMed1994

Epidural abscess in the cervical spine.

A ten-year retrospective review of 23 cases of documented spinal epidural abscess in the cervical spine was undertaken to define the clinical features and establish current diagnostic and therapeutic criteria. Diagnosis was made by magnetic resonance imaging or myelography. Risk factors included intravenous drug abuse, diabetes mellitus, previous trauma, and a positive serologic test for the human immunodeficiency virus. A bacterial agent was isolated in 21 cases (91%). Neurologic deficits were present in 20 of the cases (87%) at the time of diagnosis. Erythrocyte sedimentation rate was elevated in all patients in whom it was measured. All patients were treated with appropriate antibiotics, usually for 6 to 8 weeks. Twenty-one patients underwent operative procedures using percutaneous aspiration (1 patient), the anterior approach (14 patients) or the posterior approach (4 patients), or a combination of the two approaches (2 patients). Four of ten patients who initially had less than antigravity strength were eventually ambulatory and continent; in each case, operative decompression was performed within 36 hours of initial consultation. Three patients who had no initial neurologic deficits remained intact.

Abscess↗
PubMed1990

Spinal epidural abscesses in adults: review and report of iatrogenic cases.

A retrospective review of the medical records of adults with diagnosed spinal epidural abscess (SEA) admitted to the Departments of Neurosurgery and Infectious Diseases at the University Hospital of Umeå, Sweden, during a 10-year-period (1978-1987) is presented. 10 patients were diagnosed as having SEA during the study period. An iatrogenic origin was suspected in 5. Spondylitis was the most common source of infection. Bacteriological aetiology was confirmed in 8 cases and Staphylococcus aureus was the most common aetiological agent. Trauma and degenerative diseases of the spine, were underlying conditions in 6 cases. Laminectomy was performed in 7 cases. 5/6 patients operated within 48 h after onset of neurological symptoms improved. The remaining case with therapy resistant tuberculous spondylitis died. One patient with surgery after 96 h became paretic. 2/3 conservatively treated patients had a successful outcome while the third patient had a permanent paraparesis due to missed diagnosis. Early diagnosis and early laminectomy are still the most important prognostic factors. Recommended initial antibiotic therapy is the combination of a cephalosporin with extended spectrum and metronidazole.

Abscess↗
PubMed1997

Retropharyngeal and epidural abscess from a swallowed fish bone.

Retropharyngeal abscess is not uncommon, but the incidence of epidural extension of a retropharyngeal abscess is very rare. Intraspinal involvement of the deep neck infection should be suspected if the patient has neurologic deficits. Emergent surgical drainage and aggressive antibiotic treatment are necessary. The outcome is strongly associated with the level of neurologic function at the time of diagnosis. Contrast-enhanced computed tomography is an excellent diagnostic method for any deep neck infection. A case is presented in which a perforating pharyngeal foreign body (fish bone) induced a retropharyngeal and epidural abscess. The literature is reviewed to improve the early recognition and treatment of this complication of deep neck infection.

Brain Abscess↗
PubMed2003

Salmonella epidural abscess in sickle cell disease: failure of the nonsurgical treatment.

In patients suffering from sickle cell disease (SCD), bone is a preferred site of infection. We report the case of a five-year-and-eight-month-old black African boy with homozygous-SS disease who developed a cranial epidural abscess. This intracranial infectious complication originated from a Salmonella enteritidis osteitis of the frontal bone. Antibiotic treatment alone did not control the disease, so surgery was necessary to remove the necrotic bone and to evacuate the epidural pus. The numerous factors interfering with normal healing of a septic focus in sickle cell anemia, particularly in this previously undescribed intracranial complication, emphasize the need for a primary and early surgical treatment in similar situations.

Anemia, Sickle Cell↗
PubMed1985

Decreased morbidity from acute bacterial spinal epidural abscesses using computed tomography and nonsurgical treatment in selected patients.

We describe 5 patients with spinal epidural abscesses in whom computed tomographic scanning confirmed diagnosis without the use of myelography. One patient required urgent surgery because of rapidly deteriorating neurological status, but the other 4 were treated nonsurgically. The medical treatment of these patients and 9 others described in the literature consisted of antibiotics administered parenterally for a minimum of 8 weeks, followed by oral antibiotic therapy. Early diagnosis with computed tomographic scanning and a benign neurological state at the onset of treatment were associated with good results.

Abscess↗
PubMed2003

[A case of lumbar intradural and epidural abscesses presenting with elevated serum carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9)].

An 81-year-old woman was admitted to our service because of high fever and severe lumbar pain. Neurological examination showed a nuchal stiffness and sensory disturbance of the lower extremities. CSF findings showed significantly elevated neutrophils and decreased glucose. MRI demonstrated intradural and epidural abscesses within the lumbar canal. In early stages of the disease, we unexpectedly found the elevated serum CEA and CA19-9. Although those tumor markers showed very high titers, we never found any evidence of the malignant tumor. Interestingly, those markers obviously decreased with the improvement of the abscess within the lumbar canal. We discussed the importance of CEA and CA19-9 in the infectious neurological diseases.

Abscess↗
PubMed1990

[Spinal epidural abscess. Diagnosis of a case using nuclear magnetic resonance].

This is a case study of a six year old boy with a previous history of a contuse trauma of the cervical spinal region who later developed fever, stiffening of the neck, and signs of spinal compression. A descending myelography detected a lesion at C4. The Nuclear Magnetic Resonance study of the area showed an anterior epidural mass extending from C5 to T1 which displaced the spinal cord. Surgery revealed an epidural abscess which was drained. The patient received parenteral antibiotic therapy.

Abscess↗
PubMed1995

Piriformis pyomyositis mimicking epidural abscess in a parturient.

A case is presented of a patient who developed fever, leukocytosis, severe back pain, local overlying spinal tenderness, and left leg weakness on the fifth day postpartum. The patient had epidural anaesthesia for ten hours duration, before and during a forceps delivery. Computerized axial tomography (CT) and magnetic resonance imaging (MRI) of the pelvis and lumbar spine revealed swelling of the left iliacus and piriformis muscles, but no epidural abscess. A diagnosis of isolated piriformis pyomyositis with secondary sciatic nerve irritation was made, and the patient was treated with intravenous antibiotics, non-steroidal anti-inflammatory agents, and morphine analgesia. She made a full, uneventful recovery within 50 days, and was discharged requiring no medications.

Abscess↗