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Acute epidural abscess complicating pneumococcal meningitis in adult

Khalid Abidi1, Fatima Zohra Ahouzi, Rachid Gana

  • 1Medical Intensive Care Unit, Ibn Sina University Hospital, Rabat, Morocco. abidikhalid@invivo.edu

Southern Medical Journal
|December 2, 2010
PubMed

Insights

Acute spinal epidural abscess is a rare complication of pneumococcal meningitis in adults. New neurological deficits in meningitis patients warrant suspicion for this serious condition.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Neurosurgery

Background:

  • Bacterial meningitis, particularly pneumococcal meningitis, can have severe complications.
  • Spinal epidural abscesses are uncommon but serious conditions affecting the spinal cord.

Observation:

  • A 35-year-old male with pneumococcal meningitis developed cauda equina syndrome on day 8.
  • Symptoms included flaccid paraplegia, saddle anesthesia, and bowel/bladder dysfunction.
  • Spinal MRI revealed a lumbar epidural abscess at L2-L3.

Findings:

  • The patient underwent surgical decompression and received 8 weeks of antibiotics.
  • Progressive neurological improvement was observed over 8 months.

Implications:

  • This case highlights the importance of considering acute epidural abscess in meningitis patients presenting with new neurological deficits.
  • Early diagnosis and intervention are crucial for better outcomes in such rare complications.

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