Prakash Amulya, Raj Rishi, Jacob Aasems, Ross Douglas
Monmouth Medical Center, Long Branch, NJ, USA.
University of Kentucky, Lexington, KY, USA.
Case Rep Infect Dis. 2019 Aug 14;2019:9090462. doi: 10.1155/2019/9090462. eCollection 2019.
Spinal epidural abscess is a neurologic emergency with a potential complication to the spinal cord such as paralysis. Frequently, it has a nonspecific initial presentation such as neck or back pain, and hence there is a delay in diagnosis. We present the case of a 60-year-old Caucasian male who presented to emergency room with one week of numbness and weakness of all four extremities. Neurological examination showed variable quadriparesis. Urgent MRI of spine with contrast revealed epidural abscess in the cervical region C4-C6 with resultant cord compression, the underlying etiology for hematogenous spread of infection being pressure ulcer associated with testicular prosthesis. Urgent neurosurgical intervention was done to achieve spinal cord decompression. Both blood and pus cultures were positive for , requiring prolonged administration of intravenous antibiotics. Clinical outcome was encouraging with progressive gain in motor and sensory function. Spinal epidural abscess is a rare diagnosis; hence, clinicians should have a high index of suspicion for timely diagnosis.
脊髓硬膜外脓肿是一种神经急症，可能导致脊髓出现诸如瘫痪等并发症。通常，其初始表现不具特异性，如颈部或背部疼痛，因此诊断会出现延迟。我们报告一例60岁的白种男性病例，该患者因四肢麻木和无力一周就诊于急诊室。神经系统检查显示不同程度的四肢瘫。颈椎增强磁共振成像（MRI）显示颈4至颈6区域有硬膜外脓肿并导致脊髓受压，感染血行播散的潜在病因是与睾丸假体相关的压疮。紧急进行了神经外科干预以实现脊髓减压。血液和脓液培养均对[具体病菌]呈阳性，需要长期静脉输注抗生素。随着运动和感觉功能逐步恢复，临床结果令人鼓舞。脊髓硬膜外脓肿是一种罕见的诊断；因此，临床医生应高度怀疑以实现及时诊断。
