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Methicillin-Resistant Staphylococcus aureus Spinal Epidural Abscess: Local and Systemic Case Management
Abdurrahman F Kharbat1, Cameron T Cox1, Amanda Purcell1
1Orthopedic Surgery, Texas Tech University Health Sciences Center, Lubbock, USA.
Cureus
|April 11, 2022
Summary
Spinal epidural abscess (SEA) can present atypically. This case highlights SEA mimicking peripheral infection, emphasizing the need for broad diagnostic considerations in unusual presentations.
Area of Science:
- Neurology
- Infectious Diseases
- Neurosurgery
Background:
- Spinal epidural abscess (SEA) is a rare, serious condition.
- Typical SEA symptoms include back pain, fever, and focal neurological deficits.
- Atypical presentations can delay diagnosis and treatment.
Observation:
- A 53-year-old male presented with unilateral hand pain and swelling, initially without fever or back pain.
- Blood cultures identified methicillin-resistant Staphylococcus aureus (MRSA).
- The patient later developed back pain, leading to imaging that revealed a T5-T9 spinal epidural abscess.
Findings:
- The patient underwent surgical drainage of the SEA and debridement of the hand.
- Intraoperative cultures were negative.
- Treatment involved vancomycin and daptomycin for MRSA infection.
Implications:
- This case underscores the importance of considering SEA in patients with seemingly peripheral infections and subtle or delayed systemic symptoms.
- Atypical presentations of SEA necessitate a high index of suspicion and comprehensive diagnostic workup.
- Prompt recognition and management are crucial to prevent severe neurological complications.
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