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[Spinal epidural abscess caused by Acinetobacter baumannii mimicking a herniated lumbar disc]
C Pérez-López1, F J Villarejo-Ortega, F Carceller-Benito
1Unidad de Neurocirugía, Clínica La Luz, Madrid, España. cperezhulp@yahoo.es
Revista De Neurologia
|February 16, 2005
Summary
Vertebral epidural abscess can mimic herniated disc symptoms, necessitating its inclusion in differential diagnoses. This case highlights Acinetobacter baumanii as a rare cause of spinal epidural abscess.
Area of Science:
- Spinal Surgery
- Infectious Diseases
- Neurosurgery
Background:
- Vertebral epidural abscesses present with diverse systemic and neurological symptoms.
- Magnetic resonance imaging (MRI) is crucial for diagnosing these lesions, often showing extensive soft tissue involvement and peripheral enhancement.
Observation:
- A 35-year-old male presented with right S1 lumbar-radicular pain and positive Lasègue's sign, initially suspected as a herniated disc based on MRI findings.
- Surgical exploration revealed an epidural abscess from which Acinetobacter baumanii was isolated.
- Elevated erythrocyte sedimentation rate was the only abnormal laboratory finding.
Findings:
- The patient successfully recovered after antibiotic treatment and spinal orthosis.
- Follow-up MRI at three months showed signs of discitis, which completely resolved by eight months.
- The patient became asymptomatic with full recovery.
Implications:
- Epidural abscess should be considered in the differential diagnosis of herniated lumbar discs due to overlapping early clinical presentations.
- This report documents the first instance of an epidural abscess caused by Acinetobacter baumanii, expanding the known spectrum of causative pathogens.