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Streptococcus pneumoniae Spinal Epidural Abscess in an Immunocompetent Patient.
Salena Sinnasone1, Michelle Blyth2
1School of Medicine, Louisiana State University Health Sciences Center, New Orleans, USA.
Cureus
|October 7, 2024
Summary
Spinal epidural abscesses are rare in healthy individuals. This case highlights Streptococcus pneumoniae as a rare cause, emphasizing its consideration in immunocompetent patients presenting with severe back pain.
Area of Science:
- Neurology
- Infectious Diseases
- Neurosurgery
Background:
- Spinal epidural abscesses (SEAs) are uncommon in immunocompetent individuals.
- Common risk factors include intravenous drug use, diabetes, and prior surgery.
- Staphylococcus aureus is the most frequent pathogen identified.
Observation:
- A 50-year-old male with no prior medical history presented with progressive back pain, chills, and malaise.
- CT scans revealed epidural abscesses in the cervical (C6/7) and lumbar (L5/S1) spine.
- Blood and surgical cultures identified Streptococcus pneumoniae as the causative agent.
Findings:
- Streptococcus pneumoniae is an unusual cause of SEA, particularly in patients without predisposing conditions.
- The patient received a successful six-week course of cefazolin treatment.
- This case underscores the importance of considering pneumococcal disease in SEA differential diagnoses.
Implications:
- Highlights the need to consider Streptococcus pneumoniae in the differential diagnosis of spinal epidural abscesses, even in immunocompetent patients.
- Suggests broadening the diagnostic scope for SEA beyond typical risk factors and pathogens.
- Emphasizes the successful treatment of SEA caused by Streptococcus pneumoniae with antibiotics.
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