Servicio de Neurología, Hospital General Universitario Gregorio Marañón, Madrid, España.
Servicio de Neurocirugía, Hospital General Universitario Gregorio Marañón, Madrid, España.
Med Clin (Barc). 2019 Oct 11;153(7):290-292. doi: 10.1016/j.medcli.2019.06.003. Epub 2019 Sep 3.
Streptococcus agalactiae is an uncommon microorganism that causes spinal epidural abscess (SEA) and usually affects individuals with a predisposing condition or potential source of infection.
We present the case of an immunocompetent 53-year-old patient with an unremarkable past medical history who developed progressive low extremity weakness, bowel and bladder dysfunction and genital sensory impairment. A neurological exam on admission revealed flaccid proximal paraparesis, T10 sensory level, atonic anal sphincter and normal myotatic reflexes. Urgent neuroimaging showed a large thoracic epidural spinal abscess. Laminectomy and abscess drainage were immediately performed and systemic antibiotic treatment was initiated. Abscess cultures revealed Streptococcus agalactiae. After an exhaustive workup no predisposing factors or local or systemic source for the infection were found.
We report a singular case of spinal epidural abscess caused by Streptococcus agalactiae in a healthy patient with no predisposing factors. This case also highlights the importance of an early diagnosis and treatment to obtain a better neurological outcome.
无乳链球菌是一种不常见的微生物，可引起脊髓硬膜外脓肿（SEA），通常影响有潜在疾病或感染源的个体。
我们报告了一例免疫功能正常的 53 岁患者，无明显既往病史，出现进行性下肢无力、肠和膀胱功能障碍以及生殖器感觉障碍。入院时的神经系统检查显示弛缓性近端截瘫、T10 感觉水平、弛缓性肛门括约肌和正常的肌反射。紧急神经影像学检查显示巨大的胸段硬膜外脊髓脓肿。立即进行椎板切除术和脓肿引流，并开始全身抗生素治疗。脓肿培养显示无乳链球菌。经过详尽的检查，未发现感染的潜在因素或局部或全身来源。
我们报告了一例无潜在因素的健康患者由无乳链球菌引起的脊髓硬膜外脓肿的罕见病例。该病例还强调了早期诊断和治疗以获得更好的神经预后的重要性。
Zotero 插件