[Spinal epidural abscess due to group C Streptococcus].

Area of Science:

• Infectious Diseases
• Neurosurgery
• Microbiology

Background:

• Spinal epidural abscess (SEA) is a rare, potentially devastating condition with nonspecific symptoms.
• Diagnosis can be challenging, necessitating early recognition to prevent severe neurological deficits.
• Standard treatment involves surgical drainage and prolonged antibiotic therapy.

Observation:

• A case of a diabetic woman with SEA caused by Streptococcus equi subsp. zooepidemicus (a Group C Streptococcus) is presented.
• This pathogen is typically associated with animal infections but is emerging in human disease.
• The patient was successfully treated with intravenous followed by oral antibiotics, avoiding surgery.

Findings:

• This is the first reported case of a spinal epidural abscess caused by a Group C Streptococcus.
• Successful non-surgical management of SEA with antibiotics alone is demonstrated in this case.
• Streptococcus equi subsp. zooepidemicus can be a pathogen in human spinal epidural abscesses.

Implications:

• This case suggests that antibiotic therapy alone may be a viable treatment option for carefully selected SEA patients.
• Highlights the increasing role of zoonotic bacteria, like Group C Streptococcus, as human pathogens.
• Emphasizes the need to consider unusual pathogens in the differential diagnosis of SEA, particularly in immunocompromised individuals.