Paraplegia caused by spinal epidural abscess

Stephanides, G. C.; Gibson, R. M.

doi:10.1136/pgmj.64.754.603

Cited by 9 publications

(5 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…If the diagnosis is delayed, the further evolution of symptoms occurs in four phases: (1) localized spinal pain; (2) radicular pain and paresthesia; (3) muscular weakness, sensory loss, and sphincter dysfunction; and (4) paralysis [4]. Only a few cases of SEA with paraplegia have been reported till date [5]. SEA with paraplegia is an emergency condition that requires the urgent decompression of the spinal cord, as it may lead to a permanent neurological deficit if left untreated.…”

Section: Introductionmentioning

confidence: 99%

Spinal Epidural Abscess in Melioidosis: A Rare Case Report from Eastern India

Prabhat

Gantaguru

Behera

et al. 2019

Cureus

View full text Add to dashboard Cite

A spinal epidural abscess (SEA) is a rare condition that has a devastating impact on the patient’s health. It is difficult to diagnose and can present with a myriad of symptoms with or without the involvement of a neurological deficit. The conditions that lead to immunocompromised status, such as malnutrition, diabetes, intravenous drug abuse, previous surgical intervention, and human immunodeficiency virus (HIV) infection/acquired immune deficiency syndrome (AIDS) can predispose a patient to SEA. The most common organisms isolated from the affected patient include Staphylococcus aureus and Streptococcus species while an abscess in some cases can be caused by tuberculosis and fungal and parasitic infections. Among the other causative organisms is Burkholderia pseudomallei (B. pseudomallei), also known as Pseudomonas pseudomallei, which is a Gram-negative, bipolar, aerobic, motile, and rod-shaped bacterium. It is a soil-dwelling bacterium, which is endemic in tropical and subtropical regions worldwide, particularly in Thailand and northern Australia, and causes melioidosis. To our knowledge, SEA caused by B. pseudomallei from the Indian subcontinent has not been reported in the literature. In this case report, we present the case of a patient with SEA caused by B. pseudomallei.

show abstract

Section: Introductionmentioning

confidence: 99%

Spinal Epidural Abscess in Melioidosis: A Rare Case Report from Eastern India

Prabhat

Gantaguru

Behera

et al. 2019

Cureus

View full text Add to dashboard Cite

show abstract

“…The causes of a spinal epidural abscess are mainly hematogeneous, usually originating from a furuncle of the skin. Contagious spreading from vertebral osteomyelitis or some other foci may exist (1,3,12,13,15,16). Rapid progress of neurologic symptoms requires urgent surgical decompression by laminectomy and a delayed diagnosis may result in a persistent neurologic deficit (1,13,15).…”

Section: Discussionmentioning

confidence: 98%

Percutaneous Drainage of Abscess in Psoas Compartment and Epidural Space

Cwikiel¹

1991

Acta Radiol

View full text Add to dashboard Cite

show abstract

“…Despite the appropriate intervention, the prognosis can vary. Irreversible paraplegia is one of the gravest complications of the spinal epidural abscess [ 14 - 15 ]. Neurological recovery after the onset of paraplegia or quadriplegia due to a spinal epidural abscess varies significantly.…”

Section: Discussionmentioning

confidence: 99%

Septic Shock From Pan-Spinal Epidural Abscess Attributed to Recent Acupuncture and Trigger Point Injections for Acute Lower Back Pain in a Previously Undiagnosed Diabetic Patient: A Case Report

Usman¹,

Badar²,

Collado³

et al. 2023

Cureus

View full text Add to dashboard Cite

Epidural abscesses can lead to devastating neurological consequences if not diagnosed and managed in a timely manner, especially in immunocompromised patients. We report the case of a 60-year-old woman with undiagnosed diabetes mellitus who presented to the hospital with a complaint of progressive altered mental status for the past two days. Eight days prior to presentation, the patient tripped over a pillow at home and developed mildly nagging, acute lower back pain. Upon the recommendation of her friends, she underwent two sessions of acupuncture around the lumbar area on days six and five prior to being brought to the hospital. She also saw her primary care physician on day three prior to presentation, who performed a history and physical examination and, after feeling that she did not have any red flags, empirically administered lidocaine-based trigger point injections near the same lumbar areas with the patient's consent. On the day of presentation, the patient fell at home and was unable to walk, after which she was immediately brought to the hospital, where she demonstrated toxic metabolic encephalopathy due to diabetic ketoacidosis (DKA) and lower extremity paraplegia. Emergent imaging revealed a pan-spinal epidural abscess (PSEA) after an attempted lumbar puncture led to immediate pus in the syringe. Diagnosing an epidural abscess can be difficult as signs and symptoms can mimic other conditions such as meningitis, encephalitis, and stroke. High suspicion on the physician’s end is needed when a patient presents with acute back pain, fevers, and neurological deterioration if the condition is otherwise unexplained, and especially in the presence of risk factors for PSEA that may be recognized only upon presentation.

show abstract

Paraplegia caused by spinal epidural abscess

Abstract: Summary Two patients with spinal epidural abscess, but with different neurological outcomes, are presented. The pathogenesis, clinical features and current treatment are reviewed. The need for early diagnosis is once again stressed.

Cited by 9 publications

References 7 publications

Spinal Epidural Abscess in Melioidosis: A Rare Case Report from Eastern India

Spinal Epidural Abscess in Melioidosis: A Rare Case Report from Eastern India

Percutaneous Drainage of Abscess in Psoas Compartment and Epidural Space

Septic Shock From Pan-Spinal Epidural Abscess Attributed to Recent Acupuncture and Trigger Point Injections for Acute Lower Back Pain in a Previously Undiagnosed Diabetic Patient: A Case Report

Contact Info

Product

Resources

About