Chronic Spinal Cord Abscess in an Elderly Patient

Akhaddar, Ali; Boulahroud, Omar; Boucetta, Mohamed

doi:10.1089/sur.2010.064

“…In this case, it would have been difficult to suspect pyogenic spinal cord infection without the contrast-enhanced MRI scan. Because chronic SSAs are difficult to diagnose, we could not differentiate with IDEM tumor exactly and an exact history taking, contrast MRI are required [1][2][3][4][5][6][7][8][9][10][11][12].…”

Section: Resultsmentioning

confidence: 99%

“…However, spinal cord abscesses are still rare and difficult to treat. Although most spinal abscesses are extradural, they can also be intraduralextramedullary (IDEM) or intramedullary [1,2]. Abscess in the intradural-extramedullary space are usually called spinal subdural abscesses.…”

Section: Introductionmentioning

confidence: 99%

Spinal Subdural Abscess Mimicking An Intradural-Extramedullary Tumor- A Rare Case Scenario

2020

Adv Neur Neur Sci

0

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Spinal subdural abscesses (SSA) are very rare disease. The etiologies of SSA are hematogenous spread, iatrogenic contamination, and local extension. Elevated WBC counts, ESR, and C-reactive protein are usually found in laboratory tests. But they are not sensitive indicators of SSA, especially chronic abscesses patient tend to have a less specific characteristic. We report the case of a healthy child with subdural abscess referred to our hospital as an intradural– extramedullary (IDEM) tumor.

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“…In addition, despite epidural block was performed 2 years ago, epidural block could lead to spinal cord infection as chronic. According to previous literatures, if abscess was presented as chronic, it could be presented with less specific symptom and sign [1,11]. Considering the patient's history and MRI findings, we suspected that the lesion might be an acute aggravation of chronic subdural inflammatory change.…”

Section: Case Reportmentioning

confidence: 85%

“…In this report, symptoms of chronic abscess were not described. In some reported cases, chronic abscesses tend to have less specific symptomatology [1,11]. Leukocyte count, ESR, and C-reactive protein are not sensitive indicators of spinal infection, but are usually found to be elevated [12,13].…”

Section: Discussionmentioning

confidence: 99%

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Chronic spinal subdural abscess mimicking an intradural–extramedullary tumor

Lim

¹

,

Choi

²

,

Kim

³

et al. 2013

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Spinal subdural abscesses (SSA) are very rare disease. The etiologies of SSA are hematogenous spread, iatrogenic contamination, and local extension. Elevated WBC counts, ESR, and C-reactive protein are usually found in laboratory tests. But they are not sensitive indicators of SSA, especially chronic abscesses patient tend to have a less specific characteristic. We report the case of a healthy man with chronic subdural abscess referred to our hospital as an intradural-extramedullary (IDEM) tumor. The patient presented with voiding difficulty and pain in the back and left leg. In a contrast MRI scan, a rim-enhanced mass-like lesion was seen at the L5/S1 level. But adjacent ill-defined epidural fat enhancement that are unusual imaging manifestation for IDEM tumors was seen. He had no fever and normal WBC, ESR, and CRP. In addition, the patient had no previous infection history or other disease, but he did have an epidural block for back pain at another hospital 2 years previously. So, we repeated the MRI with a high-resolution 3-T scanner. The newly taken MR images in our hospital revealed a clear enlargement of lesion size compared to the previous MRI taken 1 week before in other hospital. We suspected a chronic spinal subdural abscess with recent aggravation and immediately performed surgical evacuation. In the surgical field, tensed dura was observed and pus was identified after opening the abscess capsule. Because chronic spinal subdural abscesses are difficult to diagnose, we could differentiate with IDEM tumor exactly and an exact history taking, contrast MRI are required.

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