1/23. Brucellar spinal epidural abscess.Spinal epidural abscesses account for approximately one of every 10, 000 admissions to tertiary hospitals. The midthoracic vertebrae are the most frequently affected, whilst the cervical spine is involved in fewer patients. staphylococcus aureus is identified as the cause in most cases of epidural abscess; other bacteria responsible include gram-negative bacteria, streptococcus species and brucella species. We report the case of a patient with cervical spondylodiscitis at level C4-C5 and an epidural abscess which was compressing the spinal cord and the retropharyngeal space. The previous symptoms of brucellosis were atypical. We discuss the clinical manifestations, diagnosis, treatment and prognosis of the case.- - - - - - - - - - ranking = 1keywords = spondylodiscitis, discitis (Clic here for more details about this article) |
2/23. psoas abscess secondary to discitis: a case report of conservative management.We report a case of secondary psoas abscess in a 37-year-old man with a 3-week history of severe low backache managed conservatively without surgical drainage. Apart from bilaterally restricted straight leg raising (<70 degrees), his neurologic examination was within normal limits. magnetic resonance imaging showed discitis of the L3-L4 space and a left-sided secondary psoas abscess. Aspiration biopsy of the abscess material under radiologic control isolated staphylococcus aureus, which responded to appropriate antibiotic therapy with complete resolution. A high index of suspicion is necessary for diagnosis of psoas abscess, which should be considered in patients with pyrexia and backache with a neurologic examination that is otherwise normal. We discuss the recommendations for surgical and nonsurgical approaches.- - - - - - - - - - ranking = 0.63283032625433keywords = discitis (Clic here for more details about this article) |
3/23. Favorable outcome of long-lasting thoracic spondylodiscitis with spinal epidural abscess induced by staphylococcus aureus.A favorable outcome in chronic spondylodiscitis with epidural abscess is rare. A 65-year-old woman developed recurrent, localized, thoracic back pain over 2.5 years. Nine months after the onset of the pain, sensory disturbances of the left lower leg occurred. Fourteen months before admission, she developed recurrent fever, bladder dysfunction, and weakness and numbness of both lower legs. An incomplete sensory transverse syndrome with paraparesis was diagnosed. magnetic resonance imaging of the spine suggested destruction of the T11 vertebral body, with spondylodiscitis of the adjacent discs and an epidural abscess between levels T4 and T9. laminectomy was immediately performed and the abscess was drained. culture revealed infection with staphylococcus aureus. After 10 weeks of therapy, recovery was almost complete. Spondylodiscitis with epidural abscess may have a favorable outcome, even if symptoms start more than 2 years before treatment.- - - - - - - - - - ranking = 6.1265660652509keywords = spondylodiscitis, discitis (Clic here for more details about this article) |
4/23. One case of gram-negative anaerobic spondylodiscitis with prevotella intermedia.We report the case of a 45-year-old woman with spondylodiscitis at L1/L2, communicating with paravertebral, intravertebral and bilateral psoas abscesses. Percutaneous computed tomography (CT)-guided abscess drainage and an intravenous antibiotic therapy with imipenem were performed. After removing the drainage at 2 weeks, the patient was discharged at 4 weeks with normalized blood parameters, normal temperature, and without need for analgesics. The underlying bacterium in the case was a very rare gram-negative anaerobic bacterium: prevotella intermedia.- - - - - - - - - - ranking = 5keywords = spondylodiscitis, discitis (Clic here for more details about this article) |
5/23. MRI demonstration of cervical spondylodiscitis and distal full-length bilateral paraspinal cold abscesses successfully treated by drug regimen only.OBJECTIVE: Cold abscesses, although common in spinal tuberculosis, are usually localized to the level of infection, follow tissue planes, and may extend into the spinal canal at any level. They may cause symptoms resulting from neurovascular compression, hemorrhage, and direct mass effect. DESIGN AND patients: We present an unusual case of cervical tuberculous spondylodiscitis in a 25-year old man with a cold abscesses involving the retropharyngeal, mediastinal, and retroperitoneal areas bilaterally. The abscess tracked from the neck to the psoas muscles bilaterally. Following the diagnosis the patient received 9 months of antituberculous therapy. RESULTS: MRI showed resolution on medical treatment alone. CONCLUSIONS: Even in the presence of massive paravertebral cold abscesses medical treatment alone may well suffice for this common worldwide disorder. MRI is ideal for monitoring regression of massive abscesses in deep anatomical locations.- - - - - - - - - - ranking = 5keywords = spondylodiscitis, discitis (Clic here for more details about this article) |
6/23. A case of brucella spondylodiscitis with extended, multiple-level involvement.brucellosis is a zoonosis that affects several organs and has a protean presentation. The authors report the case of a 61-year-old male patient with brucellar spondylodiscitis involving several vertebrae and a paravertebral abscess localized in the erector spinae muscle. diagnosis was made by positive blood culture and MRI. No relapse was seen with a combined treatment (doxycycline/rifampin) for 3 months, followed by doxycycline alone for 6 months. Almost all radiologic findings disappeared at the end of a 1-year follow-up without any further treatment.- - - - - - - - - - ranking = 5keywords = spondylodiscitis, discitis (Clic here for more details about this article) |
7/23. Spondylodiscitis due to bacteroides fragilis: two cases and review.Non-iatrogenic spondylodiscitis caused by anaerobic bacteria remains exceptional. We describe 2 cases of spondylodiscitis with epidural abscess due to Bacteroides fragilis, 1 after colonoscopy with biopsy and 1 in a cirrhotic patient. The clinical and imaging findings were not discriminant relative to other pyogenic spondylodiscitis. One should consider B. fragilis when treating a spondylodiscitis with epidural abscess, especially in patients with a possibly digestive portal of entry.- - - - - - - - - - ranking = 4.5062642610035keywords = spondylodiscitis, discitis (Clic here for more details about this article) |
8/23. Staphylococcal septic synovitis of the sternoclavicular joint with retrosternal extension.Bacterial arthritis of the sternoclavicular joint is an uncommon disorder caused by a variety of microorganisms. Both Gram-positive and gram-negative bacteria have been identified as etiologies of an acute suppurative arthritis, whereas a few other bacteria such as mycobacteria and treponemes have been incriminated in chronic disease of the sternoclavicular joint. We recently treated a patient with staphylococcal synovitis of the sternoclavicular joint, which is the 24th recorded in the literature. His illness was complicated by a retrosternal abscess, soft tissue abscess of the chest, septic bursitis, and lumbosacral discitis. He recovered after 6 weeks of nafcillin therapy without any residual infection. Six previous patients with extension into the substernal space and mediastinum have been described. Staphylococcal infection of the sternoclavicular joint, although usually confined to the joint, can be associated with sepsis and metastatic abscess formation as well as substernal extension even in immunocompetent individuals.- - - - - - - - - - ranking = 0.12656606525087keywords = discitis (Clic here for more details about this article) |
9/23. diagnosis of anterior cervical spinal epidural abscess by US and MRI in a newborn.A 10-day-old girl who initially presented with fever developed over five days a complete paresis of both upper arms and swallowing difficulty. After emergency drainage of a retropharyngeal abscess, cervical US demonstrated a cervical anterior epidural mass compressing the cord. MRI confirmed the diagnosis of spinal epidural abscess secondary to C4-C5 spondylodiscitis. Surgical removal of the abscess was followed by complete disappearance of the neurologic symptoms after six months of follow-up. This is the first case of spinal epidural abscess in a newborn to be diagnosed by US and MRI preoperatively. The advantages of these non-invasive imaging modalities are discussed, and compared to myelography.- - - - - - - - - - ranking = 1keywords = spondylodiscitis, discitis (Clic here for more details about this article) |
10/23. Septic streptococcus milleri spondylodiscitis.We describe 2 patients presenting lumbar spondylitis due to streptococcus milleri. In both cases origin was related to preexistent intestinal pathology. Surgical drainage of a collection of pus was necessary in one case. Longterm antibiotic therapy led to full recovery. Despite confused nomenclature streptococcus milleri must be considered a serious pathogen mainly associated with purulent infection with osteoarticular affinity.- - - - - - - - - - ranking = 4keywords = spondylodiscitis, discitis (Clic here for more details about this article) |
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