Isolated Spinal Subdural Empyema: A Case Report & Review of the Literature
| Autor: | Kailash Narayan, Chris Karas, Ward Buster, Rudy Marciano |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Subdural empyema
medicine.medical_specialty Spinal subdural abscess medicine.diagnostic_test Epidural abscess business.industry English language 030230 surgery Case description medicine.disease Palpation Surgery 03 medical and health sciences 0302 clinical medicine Paralysis Medicine Lumbar spine medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | Open Journal of Modern Neurosurgery. :112-119 |
| ISSN: | 2163-0585 2163-0569 |
| DOI: | 10.4236/ojmn.2017.73012 |
| Popis: | Background: Spinal subdural empyema (SSE) is rare, with less than 70 case reports in adults. The pathomechanism of infection and vulnerable patient populations have yet to be delineated. Reported outcomes are varied. Case Description: Case report of an isolated spinal subdural empyema with no obvious source in a 65-year-old female presenting with an acute neurologic deficit requiring emergent surgical intervention. A Pub Med search of keywords “Spinal Subdural Empyema” and/or “Spinal Subdural Abscess” with review of all associated English language literature was conducted. Pertinent data were compiled, analyzed, and placed into chart and graph format. Conclusions: SSE is rare and often progresses in 3 separate chronologic stages; pain/fever, neurologic deficit, and paralysis. Tenderness to palpation is often absent. 3 methods of spread have been postulated: hematogenous, contiguous, and iatrogenic. Staphylococcus aureus is the most common infecting organism. The lumbar spine, followed closely by the thoracic spine, is most commonly affected. Contrasted MRI is the preferred diagnostic modality. Emergent surgical SSE evacuation followed by parenteral antibiotics is recommended, as surgical outcomes are far superior to non-surgical management. The patient featured in this case made a full neurologic recovery by 6-month follow-up. |
| Databáze: | OpenAIRE |
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