Adult spinal epidural abscess: clinical features and prognostic factors
| Autor: | Wen-Neng Chang, Ping-Yu Lee, Cheng-Hsien Lu, Hsueh-Wen Chang, Chen-Chung Lui |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
Adult
Male medicine.medical_specialty Tuberculosis Epidural abscess Diagnosis Differential Central nervous system disease Paraparesis medicine Back pain Humans Abscess Aged Retrospective Studies business.industry Retrospective cohort study General Medicine Middle Aged Staphylococcal Infections Prognosis medicine.disease Anti-Bacterial Agents Surgery Epidural Abscess Female Neurology (clinical) Morbidity Differential diagnosis medicine.symptom business Meningitis |
| Zdroj: | Clinical Neurology and Neurosurgery. 104:306-310 |
| ISSN: | 0303-8467 |
| Popis: | Twenty-nine adult patients with spinal epidural abscess (SEA), aged 31-73 years, have been identified over a period of 8 years. The 29 SEA patients included 21 men and eight women with a mean age of 54 years. Initial diagnosis of SEA was made in only 17% of our patients and another 48% of patients were initially suggested of having infection or mass of the spine. Spinal pain and fever were the two most common clinical features shared among our patients. The two most common pathogens were Staphylococcus aureus and Mycobacterium tuberculosis, which were found in 62% of patients. Twenty-seven patients received surgical intervention and antibiotic treatment for SEAs, one of which succumbed to meningitis. Two patients without neurological abnormalities received conservative treatment alone and survived. The number of patients, which showed improvement of symptoms, included all seven patients with neck/back pain without neurologic deficits, all 15 patients with paraparesis, 10 of 13 patients with bladder/bowel dysfunction with or without motor deficits, and none of the five with plegia. Preoperative plegia was identified as a poor prognostic factor, and patients with SEA continue to show high rates of morbidity and mortality. Thus, in order to improve the therapeutic outcome of patients with SEA, early diagnosis and management are mandatory to treat the patients before the deterioration of neurologic deficit occurs. |
| Databáze: | OpenAIRE |
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