Concomitant epidural and subdural spinal abscess: a case report

被引:4
作者
Ngwenya, Laura B. [1 ,3 ]
Prevedello, Luciano M. [2 ]
Youssef, Patrick P. [1 ]
机构
[1] Ohio State Univ, Wexner Med Ctr, Dept Neurol Surg, N1014 Doan Hall,410 W 10th Ave, Columbus, OH 43210 USA
[2] Ohio State Univ, Wexner Med Ctr, Dept Radiol, Room 460,395 W 12th Ave, Columbus, OH 43210 USA
[3] Univ Calif San Francisco, Dept Neurol Surg, San Francisco Gen Hosp, Room 101,Bldg 1,1001 Potrero Ave, San Francisco, CA 94110 USA
关键词
Intravenous drug use; MRI; Spinal epidural abscess; Spinal infection; Spinal subdural abscess; Surgical management; LOW-BACK-PAIN; SURGICAL-MANAGEMENT; NONOPERATIVE TREATMENT; EMPYEMA; INFECTIONS; PATIENT; TOMOGRAPHY; INJECTION; SPACE;
D O I
10.1016/j.spinee.2015.11.060
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
BACKGROUND CONTEXT: Spinal subdural abscess (SSA) is a rare occurrence for which the management typically involves open surgical removal and washout. PURPOSE: This case report aims to review the literature and discuss the management of patients with SSA. STUDY DESIGN: We present a case of a 33-year-old female who presented with a spinal epidural abscess and concurrent SSA. She presented in the context of intravenous (IV) drug use, back pain, and generalized lower extremity weakness. METHODS: The literature was reviewed with a focus on modern treatment options for SSA. Our patient was managed with IV antibiotics, and separate laminectomies and washouts for both lesions. RESULTS: The patient recovered well with return of neurologic function and normalization of infection markers. The review of the literature resulted in a management flowchart that will help direct treatment of SSA. CONCLUSIONS: The literature suggests that in a patient with a definitive diagnosis of SSA, limited surgical management and IV antibiotics are the mainstay of treatment in a patient with a decline in neurologic function. There may be a role for expectant management in the absence of diagnostic imaging or the neurologically stable patient. (C) 2015 Elsevier Inc. All rights reserved.
引用
收藏
页码:E275 / E282
页数:8
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