Carragoso Adelino, Capelo Joana
Serviço de Medicina Interna 2, Hospital de São Teotónio, E.P.E., Rua de Santo António, 3500-184 Viseu.
Acta Reumatol Port. 2007 Jul-Sep;32(3):287-97.
Spinal epidural abscess is a rare clinical entity, presenting insidiously with nonspecific clinical manifestations. The diagnosis is usually difficult and, if not made early, the consequences may be disastrous. The therapeutic strategy consists of surgical drainage and systemic antibiotherapy for 4 to 6 weeks; in carefully selected patients, the surgical intervention may be avoided. We describe the case of a diabetic woman who presented with a spinal epidural abscess due to Streptococcus equi subsp. zooepidemicus, a group C Streptococcus, treated successfully with parenteral antibiotherapy followed by oral antibiotherapy. Group C streptococci are bacteria typically associated with disease in animals, nowadays emerging as important human pathogens. This is the first reported case of spinal epidural abscess due to a Group C Streptococcus.
脊髓硬膜外脓肿是一种罕见的临床病症,起病隐匿,临床表现不具特异性。诊断通常较为困难,若不及早诊断,后果可能不堪设想。治疗策略包括手术引流和4至6周的全身抗生素治疗;对于精心挑选的患者,可避免手术干预。我们描述了一例糖尿病女性患者的病例,该患者因马链球菌兽疫亚种(一种C组链球菌)引发脊髓硬膜外脓肿,经肠外抗生素治疗后再口服抗生素治疗,最终成功治愈。C组链球菌通常是与动物疾病相关的细菌,如今正成为重要的人类病原体。这是首例报告的由C组链球菌引起的脊髓硬膜外脓肿病例。