Cases reported "Discitis"

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1/49. 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.
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2/49. Intramedullary spinal cord abscess associated with cervical spondylodiskitis and epidural abscess.

    A 50-year-old man presented a cervical vertebral osteomyelitis and epidural abscess due to staphylococcus aureus. There were significant changes in the cervical region, as revealed by CT scan and MRI, leading to the diagnosis of associated intramedullary abscess of the spinal cord, which was confirmed by anatomopathological study.
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keywords = abscess
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3/49. 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.
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keywords = abscess
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4/49. Beware of short-course therapy for staphylococcus aureus bacteremia without a removable cause.

    staphylococcus aureus bacteremia has long been known to cause significant morbidity and mortality. The optimal treatment of this disease has evolved over the years. Recently, criteria have been established for the use of shorter courses of antibiotic therapy in certain patients, most notably those with an easily removed source of the bacteremia. We present the case of a 55-year-old man with S aureus bacteremia unrelated to an intravascular device. He was treated with "short-course" antibiotic therapy, and lumbar diskitis and an epidural abscess developed.
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5/49. Spondylodiscitis and epidural abscess due to candida albicans.

    A 32-year-old woman, addicted to heroin, presented with a dorsal spondylodiscitis due to candida albicans associated with epidural abscess. Antimycotic treatment was successful, and no neurosurgical decompression was necessary. To our knowledge, this is the first case of documented epidural involvement in candidal spondylodiscitis. The diagnosis of candidal spondylodiscitis should be considered in cases of para- or tetraplegia occurring in intravenous drug abusers.
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ranking = 0.71428571428571
keywords = abscess
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6/49. Vertebral infections caused by haemophilus aphrophilus: case report and review.

    OBJECTIVE: To review in detail clinical presentation, bacteriologic findings, associated conditions and treatment of haemophilus aphrophilus vertebral osteomyelitis and to compare them to a case we report herein. methods: A medline (National Library of medicine) search of the literature was performed by using the key words H. aphrophilus, spondylodiscitis, discitis, and vertebral osteomyelitis. The references of the case reports were examined for additional cases, especially those cited in older articles that had not been entered onto the bibliographic database. RESULTS: A case report of spondylodiscitis due to H. aphrophilus in a 35-year-old patient with a history of dental abscess 7 months before admission is presented. The patient responded well to treatment with ceftriaxone and ciprofloxacin. To date, only 14 cases of H. aphrophilus vertebral osteomyelitis have been reported. They are usually reported in middle-aged patients, usually male. Most recent cases have been treated with fluoroquinolones. Duration of treatment usually ranges from 1 to 3 months. CONCLUSIONS: H. aphrophilus is an uncommon cause of vertebral osteomyelitis. patients are regularly cured by antibiotic therapy, provided that a tissue biopsy is performed in order to isolate the causative bacterium.
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keywords = abscess
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7/49. discitis associated with pregnancy and spinal anesthesia.

    discitis (inflammation of the intervertebral disk) most commonly develops as a rare complication of bacterial infection or chemical or mechanical irritation during spine surgery (1) with a postoperative incidence of 1%-2.8% (2). It is also a complication of discography-the intradiscal injection of saline or contrast material (3). The incidence of postdiscography discitis is 1%-4% (3); no cases have been reported when prophylactic antibiotics have been used, supporting the theory of bacterial contamination (3). Although it is controversial whether discitis can be caused by an aseptic or infectious process, recent data suggest that persistent discitis is almost always bacterial (4). Honan et al. (5) reported 16 cases of spontaneous discitis and reviewed another 52 patients from the literature. In their series, patients tended to have one or more comorbid conditions, such as diabetes, vertebral fracture, or a preexisting spine injury. Spontaneous discitis has also been associated with advanced age, IV drug abuse, IV access contamination, urinary tract infection, and immunocompromised states (5,6). No cases of infectious discitis associated with pregnancy and spinal anesthesia have been reported in the English literature. discitis presents as spasmodic pain in the back that may be referred to the hips or groin (7). The pain may radiate to the lower extremities. The erythrocyte sedimentation rate is usually increased. Radiological changes in discitis include narrowing of the intervertebral disk space, vertebral sclerosis, and erosion of the end plates. The best diagnostic measure may be magnetic resonance imaging (MRI) or a combination of bone and gallium scanning (2). The mainstay for discitis treatment is pain control and antibiotics; surgical intervention is usually not required. Complications of discitis include intervertebral fusion, epidural abscess, and paralysis. IMPLICATIONS: This is a case report of a disk infection (discitis) caused by the bacteria, streptococcus bovis after spinal anesthesia for cesarean delivery. S. bovis rarely causes discitis, and spinal anesthesia for labor and delivery has not been reported as a cause of discitis.
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ranking = 0.14285714285714
keywords = abscess
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8/49. Surgical strategy for spondylodiscitis due to candida albicans in an immunocompromised host.

    A 44-year-old woman receiving systemic chemotherapy for cerebellar medulloblastoma developed thoracolumbar spondylodiscitis due to candida albicans associated with abscesses in the bilateral psoas muscles. As long-term medical therapy with fluconazole was not effective, radical removal of the affected lesions and anterior bone grafting were performed. Corpectomy of the infected vertebra with autologous bone grafting and removal of the psoas muscle were performed via the right transthoracic retroperitoneal approach. Additional posterior instrumentation was not used. Two years after the operation, the patient was doing well, and systemic chemotherapy for medulloblastoma has restarted. Corpectomy with radical resection of surrounding infectious tissues for C. albicans spondylodiscitis in an immunocompromised host should be performed when conservative medical treatment is not successful. Further instrumentation surgery might be necessary to prevent further deformity of the spine as the second surgery.
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ranking = 0.14285714285714
keywords = abscess
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9/49. psoas abscess diagnosed at a Northern university hospital.

    Abscess of the psoas muscle is an infrequent diagnosis at hospitals in Northern countries. We report on 16 patients who had this diagnosis during the period 1991-2001. Eight patients were immigrants who had previously been healthy and most of them had experienced symptoms for approximately 1 y. MRI or CT scans revealed spondylodiscitis in 6 of these patients and mycobacterium tuberculosis was identified as the causative agent. With the exception of 1 patient who was exclusively treated with antituberculous agents, all 8 immigrant patients were successfully treated with antituberculous agents in addition to percutaneous drainage. The other 8 patients were Norwegians, 4 of whom had underlying conditions such as diabetes mellitus or drug abuse. The causative microorganisms were staphylococcus aureus or Streptococcus spp., with the exception of M. tuberculosis in 1 case. The Norwegian patients had a more acute history of symptoms than the immigrant patients and 2 of them were in a septic condition on admittance. Two of the Norwegians died of serious infection; 5 were successfully treated with percutaneous drainage in addition to antibiotics and 1 was treated exclusively with antibiotic agents. The clinical history and microorganism associated with psoas abscess seemed to depend on whether or not the patient was an immigrant. Owing to increasing immigration, diagnosis of psoas abscess should be taken into account in Northern countries.
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ranking = 0.85714285714286
keywords = abscess
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10/49. 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.
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ranking = 1.1428571428571
keywords = abscess
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