Bartels R H, de Jong T R, Grotenhuis J A
University Hospital Nijmegen, Department of Neurosurgery, The Netherlands.
J Neurosurg. 1992 Feb;76(2):307-11. doi: 10.3171/jns.1992.76.2.0307.
Only 44 cases of spinal subdural abscess have been reported to date. The authors present another case and review the relevant literature. The findings of intraspinal gassification on computerized tomography scans and Escherichia coli as the causative organism have not previously been described in relation to spinal subdural abscess. Most frequently, Staphylococcus aureus is the responsible organism. Hematogenous spread of infection from a distant source often takes place. In a surprising number of incidences, iatrogenic causes are the primary foci of spinal subdural abscess. Spinal subdural abscess is an unpredictable disease, with an unfavorable outcome if left untreated. If there is suspicion of a spinal subdural abscess, urgent radiological examination followed by immediate surgical drainage and appropriate antibiotic therapy is warranted.
迄今为止,仅报告了44例脊髓硬膜下脓肿病例。作者介绍了另一例病例并回顾了相关文献。计算机断层扫描显示的脊髓内气体形成以及大肠杆菌作为病原体此前尚未在脊髓硬膜下脓肿中被描述过。最常见的病原体是金黄色葡萄球菌。感染常从远处病灶经血行播散。在数量惊人的病例中,医源性病因是脊髓硬膜下脓肿的主要病灶。脊髓硬膜下脓肿是一种不可预测的疾病,若不治疗预后不佳。如果怀疑有脊髓硬膜下脓肿,应进行紧急影像学检查,随后立即进行手术引流并给予适当的抗生素治疗。