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Lumbar spine epidural abscess and facet joint septic arthritis due to Streptococcus agalactiae: a case report

Costansia Bureta1,2, Hiroyuki Tominaga3, Takuya Yamamoto3

  • 1Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan. upendocostansia@gmail.com.

BMC Surgery
|March 15, 2018
PubMed
Abstract

Insights

This case highlights Streptococcus agalactiae causing lumbar epidural abscess and facet joint arthritis, leading to severe neurological deficits and urine retention. Prompt diagnosis and surgical intervention are critical for patient recovery.

Area of Science:

  • Infectious Diseases
  • Neurosurgery
  • Spinal Surgery

Background:

  • Reports a rare case of lumbar spine epidural abscess and facet joint septic arthritis.
  • Attributes the infection to Streptococcus agalactiae, a Group B beta-hemolytic streptococcus.
  • Notes the infection spread to iliopsoas muscles, causing urine retention.

Observation:

  • A 68-year-old woman presented with low back pain, progressing to bilateral lower limb weakness and urine retention.
  • Magnetic resonance imaging (MRI) revealed an epidural mass at T12-L4 compressing the spinal cord.
  • Group B beta-hemolytic streptococci were detected in serum, urine, and blood.

Findings:

  • Surgical intervention included T12-L4 hemilaminectomy and abscess drainage.
  • Histopathology confirmed inflammatory cell invasion of the facet joint.
  • Postoperative antibiotic treatment led to rapid clinical improvement.

Implications:

  • Emphasizes that lumbar spine epidural abscess and facet joint septic arthritis caused by Streptococcus agalactiae are clinical emergencies.
  • Highlights significant morbidity and mortality associated with delayed diagnosis and treatment.
  • Stresses the risk of severe neurological deficits, septicemia, multiorgan failure, and death if diagnosis and treatment are delayed.
Keywords:
Antibiotic administrationFacet joint septic arthritisHemilaminectomySpinal epidural abscessStreptococcus agalactiaeUrine retention

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