Abscess of cauda equina presenting as lumboischialgic pain: a

Velnar, Tomaž; Bunc, Gorazd

doi:10.5114/fn.2012.30529

Cited by 5 publications

(4 citation statements)

References 15 publications

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“… Intradural thick-walled cystic collection containing frank pus. Aspergillus fumigatus Epidural steroid injection performed 6 wk before presentation Velnar and Bunc [1] Abscess of cauda equina presenting as lumboischialgic pain: a case report Folia Neuropathologica Intradural 2 cm tumorous formation at L2, slightly on the left side of the spinal cord. No disc pathology.…”

Section: Discussionmentioning

confidence: 99%

“…Spinal intradural abscesses are an extremely rare condition. To our knowledge, only a few cases have been described in the literature with long-term sequelae (eg, neurological impairment) and poor prognosis if untreated [1] . Most commonly, intradural abscesses have been described as a consequence of a hematogenous spread of an infection, however, they may also be secondary to iatrogenic causes (eg, epidural injections) or to spondylitis phenomena [2] .…”

Section: Introductionmentioning

confidence: 99%

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Intradural abscess: A challenging diagnosis. Case series and review of the literature

Romano,

Blandino,

Romano

et al. 2023

Radiology Case Reports

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Intradural abscess: A challenging diagnosis. Case series and review of the literature

Romano,

Blandino,

Romano

et al. 2023

Radiology Case Reports

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“…MRI is the exam of choice and often diagnoses CES without yet the complete neurological entity [ 6 – 8 ]. Every emergency physician should be able to detect a patient presenting with a potential CES [ 9 ], as its early recognition could institute, thanks to early treatment, a more favourable outcome. In our case report, treatment was delayed because of the time of consultation.…”

Section: Discussionmentioning

confidence: 99%

Intramedullary Abscess byStaphylococcus aureusPresenting as Cauda Equina Syndrome to the Emergency Department

Damaskos

Jumeau

Lens

et al. 2016

Case Reports in Emergency Medicine

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Cauda equina syndrome (CES) is a rare entity presenting with low back pain, unilateral or bilateral sciatica, motor weakness of lower extremities, sensory disturbance in the perineal area, and urinary and/or faecal incontinence. Those symptoms are secondary to compression of the cauda equina. If not recognized, CES can lead to irreversible disabilities. We report the case of a 77-year-old lady who presented to the emergency department with a ten-day history of back pain as well as urinary incontinence.

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“…The prognosis of an isolated SEA may be better than that of SD with or without an epidural abscess [13]. If SIA is not treated immediately, the prognosis is poor [14,15]. The incidence, clinical course, morbidity, mortality, and optimal standardized treatment of patients with SIA are still unclear, and most evidence is based on case reports and lacks systematic analysis [2,10].…”

Section: Introductionmentioning

confidence: 99%

Diagnostics, Management, and Outcomes in Patients with Pyogenic Spinal Intra- or Epidural Abscess

Hijazi,

Siepmann,

El-Battrawy

et al. 2023

JCM

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Background: Owing to the lack of evidence on the diagnostics, clinical course, treatment, and outcomes of patients with extremely rare spinal intradural abscess (SIA) and spinal epidural abscess (SEA), we retrospectively analyzed and compared a cohort of patients to determine the phenotyping of both entities. Methods: Over a period of 20 years, we retrospectively analyzed the electronic medical records of 78 patients with SIA and SEA. Results: The patients with SIA showed worse motor scores (MS scores) on admission (SIA: 20 ± 26 vs. SEA: 75 ± 34, p < 0.001), more often with an ataxic gait (SIA: 100% vs. SEA: 31.8%, p < 0.001), and more frequent bladder or bowel dysfunction (SIA: 91.7% vs. SEA: 27.3%, p < 0.001) compared to the SEA patients. Intraoperative specimens showed a higher diagnostic sensitivity in the SEA patients than the SIA patients (SIA: 66.7% vs. SEA: 95.2%, p = 0.024), but various pathogens such as Staphylococcus aureus (SIA 33.3% vs. SEA: 69.4%) and Streptococci and Enterococci (SIA 33.3% vs. SEA: 8.1%, p = 0.038) were detected in both entities. The patients with SIA developed sepsis more often (SIA: 75.0% vs. SEA: 18.2%, p < 0.001), septic embolism (SIA: 33.3% vs. SEA: 8.3%, p = 0.043), signs of meningism (SIA: 100% vs. 18.5%, p < 0.001), ventriculitis or cerebral abscesses (SIA: 41.7% vs. SEA: 3.0%, p < 0.001), and pneumonia (SIA: 58.3% vs. SEA: 13.6%, p = 0.002). The mean MS score improved in both patient groups after surgery (SIA: 20 to 35 vs. SEA: 75 to 90); however, the SIA patients showed a poorer MS score at discharge (SIA: 35 ± 44 vs. SEA: 90 ± 20, p < 0.001). C-reactive protein (CrP) (SIA: 159 to 49 vs. SEA: 189 to 27) and leukocyte count (SIA: 15 to 9 vs. SEA: 14 to 7) were reduced at discharge. The SIA patients had higher rates of disease-related mortality (SIA: 33.3% vs. SEA: 1.5%, p = 0.002), had more pleural empyema (SIA: 58.3% vs. SEA: 13.6%, p = 0.002), required more than one surgery (SIA: 33.3% vs. SEA 13.6%, p = 0.009), were treated longer with intravenous antibiotics (7 ± 4 w vs. 3 ± 2 w, p < 0.001) and antibiotics overall (12 ± 10 w vs. 7 ± 3 w, p = 0.022), and spent more time in the hospital (SIA: 58 ± 36 vs. SEA: 26 ± 20, p < 0.001) and in the intensive care unit (SIA: 14 ± 18 vs. SEA: 4 ± 8, p = 0.002). Conclusions: Our study highlighted distinct clinical phenotypes and outcomes between both entities, with SIA patients displaying a markedly less favorable disease course in terms of complications and outcomes.

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Abscess of cauda equina presenting as lumboischialgic pain: a

Cited by 5 publications

References 15 publications

Intradural abscess: A challenging diagnosis. Case series and review of the literature

Intradural abscess: A challenging diagnosis. Case series and review of the literature

Intramedullary Abscess byStaphylococcus aureusPresenting as Cauda Equina Syndrome to the Emergency Department

Diagnostics, Management, and Outcomes in Patients with Pyogenic Spinal Intra- or Epidural Abscess

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