Disco vertebral osteomyelitis causing intradural spinal abscess with cauda equina compression.
Anan Shtaya1, Samantha Hettige1
1a Academic Neurosurgery Unit, Atkinson Morley Neurosurgery Centre , St George's, University of London , London , UK.
British Journal of Neurosurgery
|June 23, 2017
Summary
Intradural extramedullary spinal infections are rare. This case highlights Escherichia coli causing lumbar discitis and cauda equina compression within the dura, requiring surgical decompression and antibiotics.
Area of Science:
- Neurosurgery
- Infectious Diseases
- Spinal Surgery
Background:
- Intradural extramedullary spinal infections leading to cauda equina syndrome are infrequently encountered.
- Escherichia coli bacteraemia can present with unusual spinal manifestations.
Observation:
- A patient presented with symptoms suggestive of cauda equina compression.
- Initial imaging suggested an epidural empyema, but surgical exploration revealed an intradural abscess.
- The abscess was associated with lumbar discitis caused by Escherichia coli.
Findings:
- Successful microsurgical decompression and drainage of the intradural abscess were performed.
- Postoperative antibiotic treatment targeted the identified Escherichia coli infection.
- Management included addressing the spinal infection and subsequent neuropathy.
Implications:
- This case underscores the importance of considering intradural pathology in spinal infections presenting with cauda equina compression.
- Prompt diagnosis and surgical intervention are critical for favorable neurological outcomes.
- Comprehensive management involving antibiotics and supportive care is essential for recovery.
