Favorable Outcome of Long-lasting Thoracic Spondylodiscitis with Spinal Epidural Abscess Induced by Staphylococcus aureus

Abstract

A favorable outcome in chronic spondylodiscitis with epidural abscess is rare. A 65-year-old woman developed recurrent, localized, thoracic back pain over 2.5 years. Nine months after the onset of the pain, sensory disturbances of the left lower leg occurred. Fourteen months before admission, she developed recurrent fever, bladder dysfunction, and weakness and numbness of both lower legs. An incomplete sensory transverse syndrome with paraparesis was diagnosed. Magnetic resonance imaging of the spine suggested destruction of the T11 vertebral body, with spondylodiscitis of the adjacent discs and an epidural abscess between levels T4 and T9. Laminectomy was immediately performed and the abscess was drained. Culture revealed infection with Staphylococcus aureus. After 10 weeks of therapy, recovery was almost complete. Spondylodiscitis with epidural abscess may have a favorable outcome, even if symptoms start more than 2 years before treatment.

The evaluation of the clinical, laboratory and the radiological fi ndings of the fi ft y-fi ve cases diagnosed with tuberculous, brucellar and pyogenic spondylodiscitis

“…In developed countries, Mycobacterium tuberculosis, fungal infections and parasitic infestations are common in immunosupressve patients. [15][16][17] In the countries with prevalent tuberculosis and brucellosis such as our country, granulomatous SDs cases are of the major clinical forms. [13,[18][19][20][21] In our study, PSD rate is also signifi cant (36%).…”

Spondylodiscitis in a Geriatric Male

“…The association between symptoms and imaging results often feeble [16]. In the literature fever suggests the possibility of spinal infection as spondylodiscitis, discitis, vertebral osteomyelitis, and epidural abscess [14,17]; the infection is usually the result ofsystemic bacteremia from a distant septic focusand predisposing factors include immunosuppression,diabetes, underlying diseases, intravenous drug abuse,previous spinal surgery, and spinal anesthetic procedures [18].…”

Spondylodiscitis after bilateral sequential lung transplantation in a patient with cystic fibrosis

“…The diagnosis of spondylodiscitis may be delayed because the initial symptoms are nonspecific (8). Treatment includes medical and surgical management (5, 8, 12) or conservative methods (antibiotics and bracing) alone (11, 13, 14). Our patient had no neurological manifestations and responded to medical therapy alone; no surgery was necessary.…”

“…Spinal infections described in the literature include spondylodiscitis, discitis, vertebral osteomyelitis, and epidural abscess (5–8). Because the symptoms are nonspecific, the diagnosis relies on magnetic resonance imaging (MRI), cultures, and inflammatory markers (6).…”