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Epidural Abscess (epidural + abscess)

Distribution by Scientific Domains
Medical Sciences100%

Selected Abstracts

The Incidence of Spontaneous Epidural Abscess in Olmsted County from 1990 Through 2000: A Rare Cause of Spinal Pain

PAIN MEDICINE, Issue 4 2007
Anne E. Ptaszynski MD
ABSTRACT Objective., The primary objective of this study is to determine the population-based incidence of spontaneous epidural abscess. The secondary objective is to characterize the clinical course of patients with this rare infectious disease. Design., The records-linkage system of the Rochester Epidemiology Project was used to identify incident cases of spontaneous epidural abscess in residents of Olmsted County, Minnesota, USA, from 1990 through 2000. Setting., Tertiary referral medical center. Patients., All patients were residents of Olmsted County and had spontaneous epidural abscesses that were radiographically or surgically confirmed. Results., Eight patients, including six women, were identified and the mean age was 56 years (range, 40,80). The incidence of epidural abscess was 0.88 cases per 100,000 person-years (95% confidence interval, 0.27,1.48). The median time from symptom onset to diagnosis was 18 days (interquartile range, 4,30 days). Six patients presented with spinal pain and one presented with focal neurological deficits. Risk factors were identified in all patients, including concomitant infections, diabetes mellitus, immunosuppression, and intravenous substance abuse. Staphylococcus aureus was cultured in six patients and streptococcal species were cultured in two patients. Three patients were treated surgically and five received medical treatment. One patient treated surgically and one patient treated medically had residual neurological deficits. One patient, who was immunosuppressed and received medical treatment died of pneumonia. Conclusions., This is the first published report of the population-based incidence of spontaneous epidural abscess. These findings could serve as a reference point for further epidemiological research related to this uncommon infection. [source]

Spinal Epidural Abscess as a Result of Dissemination from Gluteal Abscess Secondary to Intramuscular Analgesic Injection

PAIN PRACTICE, Issue 5 2009
Mehdi Sasani MD
Abstract Spinal epidural abscess is a collection of suppurative material that forms between the dura mater and the ligamentum flavum. If not recognized early and treated correctly, it can lead to life-threatening sepsis. Here we report the case of a female patient, 51 years of age, with difficulty walking and bilateral leg pain after having had degenerative discogenic pain for many years. The patient had occasionally received intramuscular non-steroidal anti-inflammatory drug injections. The current report is that of an unusual case of epidural abscess that formed following multiple dose of intramuscular non-steroidal anti-inflammatory drug over a 1-year period. Hematogenous or direct dissemination is the suspected cause. To prevent serious morbidity and mortality, early diagnosis is essential. Patients with localized back pain who are at risk for developing such epidural spinal abscesses should receive a magnetic resonance imaging scan with contrast enhancement without delay. The existence of predisposing factors such as intramuscular injections should be considered in the assessment of suspected spinal epidural abscess. [source]

Epidural abscess following epidural analgesia in pediatric patients

PEDIATRIC ANESTHESIA, Issue 9 2005
YUAN-CHI LIN MD MPH
Summary Epidural abscess following epidural analgesia is an unusual event especially in pediatric patients. Two patients presented with fever and local signs of infection without neurological deficit on day 4 after the initiation of epidural analgesia. Neuro-imaging studies revealed epidural abscess. Both pediatric patients were treated successfully with intravenous antibiotics. One of the patients' initial MRI was normal. However, the symptoms persisted and a followed-up scan revealed epidural abscess. The other patient presented with worsening local indurations over the epidural insertion site and positive blood culture with Hemolytic streptococcus. Our experience suggests that neuro-imaging study should be strongly considered to evaluate pediatric patients with suspicion of epidural abscess. [source]

Neurological complications in two children with Lemierre syndrome

DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 8 2010
BASHEER PEER MOHAMED
Lemierre syndrome is a distinct clinical syndrome comprising oropharyngeal sepsis and fever, internal jugular vein thrombosis and remote septic metastases caused by Fusobacterium species. The mortality rate was historically high and although use of antibiotics led to a dramatic fall in incidence, a resurgence has been seen recently. A 14-year-old male developed Lemierre syndrome after tonsillitis. There was extensive leptomeningitis, especially over the clivus, causing 6th and 12th cranial nerve palsies, a clinical feature termed the ,clival syndrome'. He also developed an epidural abscess in the cervical spine, which was unsafe for surgical drainage. Conservative treatment with an extended course of antibiotics and anticoagulation for jugular vein thrombosis led to a good recovery. A 15-year-old female developed Lemierre syndrome after a persistent sore throat lasting 7 weeks. She had palsy of the 12th cranial nerve from clival osteomyelitis. She was treated with a 6-week course of antibiotics and anticoagulants leading to almost full recovery at 3-month review. Awareness of the potential neurological complications of Lemierre syndrome and prompt management are crucial in reducing morbidity and mortality in this ,forgotten disease'. [source]

The Incidence of Spontaneous Epidural Abscess in Olmsted County from 1990 Through 2000: A Rare Cause of Spinal Pain

PAIN MEDICINE, Issue 4 2007
Anne E. Ptaszynski MD
ABSTRACT Objective., The primary objective of this study is to determine the population-based incidence of spontaneous epidural abscess. The secondary objective is to characterize the clinical course of patients with this rare infectious disease. Design., The records-linkage system of the Rochester Epidemiology Project was used to identify incident cases of spontaneous epidural abscess in residents of Olmsted County, Minnesota, USA, from 1990 through 2000. Setting., Tertiary referral medical center. Patients., All patients were residents of Olmsted County and had spontaneous epidural abscesses that were radiographically or surgically confirmed. Results., Eight patients, including six women, were identified and the mean age was 56 years (range, 40,80). The incidence of epidural abscess was 0.88 cases per 100,000 person-years (95% confidence interval, 0.27,1.48). The median time from symptom onset to diagnosis was 18 days (interquartile range, 4,30 days). Six patients presented with spinal pain and one presented with focal neurological deficits. Risk factors were identified in all patients, including concomitant infections, diabetes mellitus, immunosuppression, and intravenous substance abuse. Staphylococcus aureus was cultured in six patients and streptococcal species were cultured in two patients. Three patients were treated surgically and five received medical treatment. One patient treated surgically and one patient treated medically had residual neurological deficits. One patient, who was immunosuppressed and received medical treatment died of pneumonia. Conclusions., This is the first published report of the population-based incidence of spontaneous epidural abscess. These findings could serve as a reference point for further epidemiological research related to this uncommon infection. [source]

Spinal Epidural Abscess as a Result of Dissemination from Gluteal Abscess Secondary to Intramuscular Analgesic Injection

PAIN PRACTICE, Issue 5 2009
Mehdi Sasani MD
Abstract Spinal epidural abscess is a collection of suppurative material that forms between the dura mater and the ligamentum flavum. If not recognized early and treated correctly, it can lead to life-threatening sepsis. Here we report the case of a female patient, 51 years of age, with difficulty walking and bilateral leg pain after having had degenerative discogenic pain for many years. The patient had occasionally received intramuscular non-steroidal anti-inflammatory drug injections. The current report is that of an unusual case of epidural abscess that formed following multiple dose of intramuscular non-steroidal anti-inflammatory drug over a 1-year period. Hematogenous or direct dissemination is the suspected cause. To prevent serious morbidity and mortality, early diagnosis is essential. Patients with localized back pain who are at risk for developing such epidural spinal abscesses should receive a magnetic resonance imaging scan with contrast enhancement without delay. The existence of predisposing factors such as intramuscular injections should be considered in the assessment of suspected spinal epidural abscess. [source]

Epidural abscess following epidural analgesia in pediatric patients

PEDIATRIC ANESTHESIA, Issue 9 2005
YUAN-CHI LIN MD MPH
Summary Epidural abscess following epidural analgesia is an unusual event especially in pediatric patients. Two patients presented with fever and local signs of infection without neurological deficit on day 4 after the initiation of epidural analgesia. Neuro-imaging studies revealed epidural abscess. Both pediatric patients were treated successfully with intravenous antibiotics. One of the patients' initial MRI was normal. However, the symptoms persisted and a followed-up scan revealed epidural abscess. The other patient presented with worsening local indurations over the epidural insertion site and positive blood culture with Hemolytic streptococcus. Our experience suggests that neuro-imaging study should be strongly considered to evaluate pediatric patients with suspicion of epidural abscess. [source]

Spondylodiscitis due to Propionibacterium acnes: report of twenty-nine cases and a review of the literature

CLINICAL MICROBIOLOGY AND INFECTION, Issue 4 2010
I. Uçkay
Clin Microbiol Infect 2010; 16: 353,358 Abstract Propionibacterium acnes is the most frequent anaerobic pathogen found in spondylodiscitis. A documented case required microbiological proof of P. acnes with clinical and radiological confirmation of inflammation in a localized region of the spine. Microbiological samplings were obtained by surgery or aspiration under radiological control. Twelve males and 17 females (median age, 42 years) with spondylodiscitis due to P. acnes were diagnosed within the last 15 years. Three patients were immunosuppressed. All patients reported back pain as the main symptom, and most were afebrile. Three patients had a peripheral neurological deficit, one a motor deficit, and two a sensory deficit attributable to the infection; and six patients had an epidural abscess. The most frequent risk factor was surgery, which was present in the history 28 of 29 (97%) patients. The mean delay between spinal surgery and onset of disease was 34 months, with a wide range of 0,156 months. Osteosynthesis material was present in twenty-two cases (76%). In 24 (83%) patients, additional surgery, such as débridement or spondylodesis, was performed. Previous osteosynthesis material was removed in 17 of the 22 (77%) patients where it was present. Total cure was reported in all patients, except one, after a mean duration of antibiotic therapy of 10.5 weeks (range, 2,28 weeks). In conclusion, spondylodiscitis due to P. acnes is an acute infection closely related to previous surgery. The most prominent clinical feature is pain, whereas fever is rare, and the prognosis is very good. [source]

The Incidence of Spontaneous Epidural Abscess in Olmsted County from 1990 Through 2000: A Rare Cause of Spinal Pain

PAIN MEDICINE, Issue 4 2007
Anne E. Ptaszynski MD
ABSTRACT Objective., The primary objective of this study is to determine the population-based incidence of spontaneous epidural abscess. The secondary objective is to characterize the clinical course of patients with this rare infectious disease. Design., The records-linkage system of the Rochester Epidemiology Project was used to identify incident cases of spontaneous epidural abscess in residents of Olmsted County, Minnesota, USA, from 1990 through 2000. Setting., Tertiary referral medical center. Patients., All patients were residents of Olmsted County and had spontaneous epidural abscesses that were radiographically or surgically confirmed. Results., Eight patients, including six women, were identified and the mean age was 56 years (range, 40,80). The incidence of epidural abscess was 0.88 cases per 100,000 person-years (95% confidence interval, 0.27,1.48). The median time from symptom onset to diagnosis was 18 days (interquartile range, 4,30 days). Six patients presented with spinal pain and one presented with focal neurological deficits. Risk factors were identified in all patients, including concomitant infections, diabetes mellitus, immunosuppression, and intravenous substance abuse. Staphylococcus aureus was cultured in six patients and streptococcal species were cultured in two patients. Three patients were treated surgically and five received medical treatment. One patient treated surgically and one patient treated medically had residual neurological deficits. One patient, who was immunosuppressed and received medical treatment died of pneumonia. Conclusions., This is the first published report of the population-based incidence of spontaneous epidural abscess. These findings could serve as a reference point for further epidemiological research related to this uncommon infection. [source]