Pan-regional (cervico-thoraco-lumbo-sacral) spinal epidural abscess with multi-level discitis, vertebral body osteomyelitis and facet joint septic arthritis: complete resolution with non-operative management
Background and importance: Pan-regional (i.e. cervico-thoraco-lumbo-sacral [CTLS]) spinal epidural abscess (SEA) is rare: only 7 cases have been reported to date. Clinical presentation: A 68 year old male, without immunosuppression, presented with severe thoracic back pain and fulminant septicaemia....
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| Format: | Article |
| Language: | English |
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Elsevier
2014-12-01
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| Series: | Interdisciplinary Neurosurgery |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S221475191400022X |
| _version_ | 1818986655084707840 |
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| author | Appukutty Manickam, MRCS Laurence A.G. Marshman, MD, FRACS Ipeson P. Korah, MBBS, DMRD |
| author_facet | Appukutty Manickam, MRCS Laurence A.G. Marshman, MD, FRACS Ipeson P. Korah, MBBS, DMRD |
| author_sort | Appukutty Manickam, MRCS |
| collection | DOAJ |
| description | Background and importance: Pan-regional (i.e. cervico-thoraco-lumbo-sacral [CTLS]) spinal epidural abscess (SEA) is rare: only 7 cases have been reported to date.
Clinical presentation: A 68 year old male, without immunosuppression, presented with severe thoracic back pain and fulminant septicaemia. CT and MRI revealed a Pan-regional CTLS SEA associated with multi-level discitis, vertebral body osteomyelitis and facet joint septic arthritis. Blood cultures grew Staphylococcus aureus sensitive to flucloxacillin and rifampicin. Given the extent of suppuration, the lack of a clinical spinal ‘level’, as well as haemodynamic instability, neurosurgical management was conservative: with intravenous flucloxacillin and rifampicin. Over several weeks, his condition slowly improved: but at no point was any spinal ‘level’ apparent neurologically. He eventually made a complete clinical and radiological recovery without any operation which was maintained at one year review.
Conclusion: Even pan-regional CTLS SEA with multi-level discitis, vertebral body osteomyelitis and facet joint septic arthritis can be managed non-operatively. A complete clinical and radiological resolution can be achieved with antibiotics alone. |
| first_indexed | 2024-12-20T18:54:14Z |
| format | Article |
| id | doaj.art-2cce1ad9da5c403c8e4bb3351d8b826d |
| institution | Directory Open Access Journal |
| issn | 2214-7519 |
| language | English |
| last_indexed | 2024-12-20T18:54:14Z |
| publishDate | 2014-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Interdisciplinary Neurosurgery |
| spelling | doaj.art-2cce1ad9da5c403c8e4bb3351d8b826d2022-12-21T19:29:33ZengElsevierInterdisciplinary Neurosurgery2214-75192014-12-0114697210.1016/j.inat.2014.05.002Pan-regional (cervico-thoraco-lumbo-sacral) spinal epidural abscess with multi-level discitis, vertebral body osteomyelitis and facet joint septic arthritis: complete resolution with non-operative managementAppukutty Manickam, MRCS0Laurence A.G. Marshman, MD, FRACS1Ipeson P. Korah, MBBS, DMRD2Department of Neurosurgery, the Townsville Hospital, Queensland 4810, AustraliaDepartment of Neurosurgery, the Townsville Hospital, Queensland 4810, AustraliaDepartment Neuroradiology, the Townsville Hospital, Queensland 4810, AustraliaBackground and importance: Pan-regional (i.e. cervico-thoraco-lumbo-sacral [CTLS]) spinal epidural abscess (SEA) is rare: only 7 cases have been reported to date. Clinical presentation: A 68 year old male, without immunosuppression, presented with severe thoracic back pain and fulminant septicaemia. CT and MRI revealed a Pan-regional CTLS SEA associated with multi-level discitis, vertebral body osteomyelitis and facet joint septic arthritis. Blood cultures grew Staphylococcus aureus sensitive to flucloxacillin and rifampicin. Given the extent of suppuration, the lack of a clinical spinal ‘level’, as well as haemodynamic instability, neurosurgical management was conservative: with intravenous flucloxacillin and rifampicin. Over several weeks, his condition slowly improved: but at no point was any spinal ‘level’ apparent neurologically. He eventually made a complete clinical and radiological recovery without any operation which was maintained at one year review. Conclusion: Even pan-regional CTLS SEA with multi-level discitis, vertebral body osteomyelitis and facet joint septic arthritis can be managed non-operatively. A complete clinical and radiological resolution can be achieved with antibiotics alone.http://www.sciencedirect.com/science/article/pii/S221475191400022XTotal spinalEpiduralAbscess |
| spellingShingle | Appukutty Manickam, MRCS Laurence A.G. Marshman, MD, FRACS Ipeson P. Korah, MBBS, DMRD Pan-regional (cervico-thoraco-lumbo-sacral) spinal epidural abscess with multi-level discitis, vertebral body osteomyelitis and facet joint septic arthritis: complete resolution with non-operative management Interdisciplinary Neurosurgery Total spinal Epidural Abscess |
| title | Pan-regional (cervico-thoraco-lumbo-sacral) spinal epidural abscess with multi-level discitis, vertebral body osteomyelitis and facet joint septic arthritis: complete resolution with non-operative management |
| title_full | Pan-regional (cervico-thoraco-lumbo-sacral) spinal epidural abscess with multi-level discitis, vertebral body osteomyelitis and facet joint septic arthritis: complete resolution with non-operative management |
| title_fullStr | Pan-regional (cervico-thoraco-lumbo-sacral) spinal epidural abscess with multi-level discitis, vertebral body osteomyelitis and facet joint septic arthritis: complete resolution with non-operative management |
| title_full_unstemmed | Pan-regional (cervico-thoraco-lumbo-sacral) spinal epidural abscess with multi-level discitis, vertebral body osteomyelitis and facet joint septic arthritis: complete resolution with non-operative management |
| title_short | Pan-regional (cervico-thoraco-lumbo-sacral) spinal epidural abscess with multi-level discitis, vertebral body osteomyelitis and facet joint septic arthritis: complete resolution with non-operative management |
| title_sort | pan regional cervico thoraco lumbo sacral spinal epidural abscess with multi level discitis vertebral body osteomyelitis and facet joint septic arthritis complete resolution with non operative management |
| topic | Total spinal Epidural Abscess |
| url | http://www.sciencedirect.com/science/article/pii/S221475191400022X |
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