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Metastatic spinal abscesses from diabetic foot osteomyelitis
Shang Shaho1, Shaila Khan1, M S Bobby Huda1
1Department of Diabetes and Metabolism, Barts and the London NHS Trust, London, UK.
BMJ Case Reports
|June 13, 2014
Summary
A patient with diabetes experienced sepsis from a foot ulcer, leading to spinal cord abscesses and severe paralysis. Despite treatment, the neurological damage required extensive rehabilitation.
Area of Science:
- Neurology
- Infectious Diseases
- Diabetology
Background:
- A 66-year-old male with type 2 diabetes, nephropathy, and neuropathy presented with a severe infected neuropathic ulcer.
- Comorbidities included long-standing diabetes with complications.
Observation:
- The patient rapidly deteriorated with sepsis and right lobar pneumonia.
- Methicillin-sensitive Staphylococcus aureus was identified.
- Flaccid paraparesis developed, with MRI revealing multiple epidural abscesses and likely spinal cord infarction.
Findings:
- The spinal epidural abscesses were not amenable to surgical intervention.
- Sepsis resolved, but severe paraparesis persisted.
- The patient required specialized spinal rehabilitation.
Implications:
- This case highlights the severe neurological complications that can arise from diabetic foot infections.
- Early recognition and management of sepsis and spinal complications are crucial.
- Neuropathic ulcers in diabetic patients pose a significant risk for invasive infections and neurological sequelae.
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