Disseminated Spinal Epidural Abscess in an Immunocompetent Individual: A Case Report and Review of the Literature.
Epidural abscess
Fever
Immunocompetence
Low back pain
Magnetic resonance imaging
Journal
Journal of medical cases
ISSN: 1923-4155
Titre abrégé: J Med Cases
Pays: Canada
ID NLM: 101551824
Informations de publication
Date de publication:
Dec 2020
Dec 2020
Historique:
received:
05
10
2020
accepted:
12
10
2020
entrez:
26
8
2021
pubmed:
27
8
2021
medline:
27
8
2021
Statut:
ppublish
Résumé
Spinal epidural abscess (SEA) is an uncommon pyogenic infection, localized between the dura mater and vertebral periosteum, leading to significant morbidity and mortality. SEA development is connected with medical comorbidities and risk factors facilitating bacterial dissemination; multiple factors are believed to play a role, including aging, increased alcohol abuse, use of intravenous drugs, a greater prevalence of medical comorbidities, and increased rates of spinal surgery that furthers iatrogenic spinal infection. Here, we have reported the first known case of disseminated SEA in an immunocompetent individual. A 33-year-old Japanese woman visited our hospital due to 1 week of continuous fever, low back pain, and numbness of the entire left lower limb. She was diagnosed with disseminated SEA by complete spine magnetic resonance imaging scan, of unknown origin. She was treated for 13 days with piperacillin-tazobactam, then for 16 days with levofloxacin tablets; ultimately, she recovered without treatment complications. This case highlights the complicated pathology, diagnosis, and treatment of SEA. In addition, this case suggests the need for a careful and detailed examination when encountering patients presenting with fever, low back pain even in an immunocompetent individual; we should thoroughly investigate, including further image investigations, bacteriological and pathologic examination.
Identifiants
pubmed: 34434354
doi: 10.14740/jmc3603
pmc: PMC8383548
doi:
Types de publication
Case Reports
Langues
eng
Pagination
417-425Informations de copyright
Copyright 2020, Usuda et al.
Déclaration de conflit d'intérêts
None to declare.
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