Streptococcus gallolyticus-related spinal epidural abscess

Abstract

Spinal epidural abscess (SEA) is a surgical emergency if it causes paraplegia. Staphylococcus aureus and streptococci are the most common causes. Streptococcus gallolyticus has been reported to cause SEA only on three occasions earlier—all were associated with endocarditis or colonic malignancy. We report an older woman with diabetic ketoacidosis who presented with poorly localised back pain, fever and altered sensorium. Her lumbar puncture revealed frank pus, and MRI showed an SEA. She could not be weaned from mechanical ventilation post-surgical decompression, and she succumbed to ventilator-associated pneumonia. A triad of fever, back pain and neurological deficit should lead one to consider intraspinal suppuration. This report is the first S. gallolyticus-related SEA from India and the first in literature that was not associated with either endocarditis or colonic malignancy.

Acute Paraplegia Caused by Spinal Epidural Empyema Following Infectious Cellulitis of the Hand: Case Report and Literature Review

“…Common symptoms of SEA include back pain, fever, muscle weakness, and numbness in the limbs [60,2]. It is considered a neurological emergency, as compression of the spinal cord can lead to serious neurological complications, including paraplegia and loss of limb function [60,2].…”

“…10,11 Common symptoms of SEA include back pain, fever, muscle weakness, and numbness in the limbs. 7,12 It is considered a neurological emergency, as compression of the spinal cord can lead to serious neurological complications, including paraplegia and loss of limb function. 7,12 Early diagnosis and immediate treatment may include antibiotics, surgical drainage, and treatment of the underlying cause of the infection and are essential to prevent permanent damage.…”

“…7,12 It is considered a neurological emergency, as compression of the spinal cord can lead to serious neurological complications, including paraplegia and loss of limb function. 7,12 Early diagnosis and immediate treatment may include antibiotics, surgical drainage, and treatment of the underlying cause of the infection and are essential to prevent permanent damage. 1,7 We present a case report of a young adult patient who developed SEA after presenting with an infectious cellulitis in the left hand.…”

Complete Genome Sequence of Streptococcus gallolyticus Strain XH2168

“… S. gallolyticus is one of the main causes of infective endocarditis, reportedly causing 2% to 10% of cases ( 1 ). In addition, it is one of the few intestinal bacteria that has been consistently linked to colorectal cancer (CRC) and spinal epidural abscess ( 2 , 3 ). To contribute to clinical practice, an in-depth study of this bacterium is warranted.…”