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Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review
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Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review

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A case of panspinal epidural abscess that presented with meningeal irritation

Naoki Okada1, Takashi Nishiyama1, Maki Kurihara1

  • 1Department of Disaster and Emergency Medicine Kobe University Graduate School of Medicine Kobe City Hyogo Japan.

Acute Medicine & Surgery
|November 11, 2017
PubMed
Abstract

Insights

A rare, extensive spinal epidural abscess mimicking bacterial meningitis was diagnosed. Prompt surgical intervention led to a satisfactory outcome, highlighting the importance of early diagnosis and treatment for spinal epidural abscess.

Area of Science:

  • Infectious Diseases
  • Neurosurgery
  • Radiology

Background:

  • Spinal epidural abscess (SEA) is a rare condition that can cause severe neurological deficits and sepsis.
  • Prompt diagnosis and treatment are crucial for favorable outcomes.

Observation:

  • A 65-year-old male presented with symptoms consistent with bacterial meningitis.
  • Magnetic resonance imaging revealed an extensive spinal epidural abscess spanning the cervical to lumbar spine.
  • Blood cultures identified Staphylococcus aureus, and concurrent abscesses were noted in the mediastinum and psoas muscles.

Findings:

  • Initial medical management was initiated due to the absence of neurological deficits.
  • Persistent positive blood cultures prompted surgical intervention.
  • Surgical treatment resulted in a satisfactory postoperative course.

Implications:

  • SEA can present with symptoms mimicking meningitis, necessitating thorough spinal evaluation.
  • Early and comprehensive imaging of the entire spine and paraspinal regions is vital for diagnosing extensive SEA.
  • Timely surgical intervention, alongside appropriate antimicrobial therapy, is essential for managing complex SEA cases.
Keywords:
bacterial meningitisepidural abscessmagnetic resonance imagingmeningitispsoas abscess

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