Manoku Eni, Piedade Guilherme S, Gelhardt Andreas L, Cordeiro Joacir G, Terzis Jorge A
Department of Neurosurgery, Helios Universitätsklinikum Wuppertal, Wuppertal, DEU.
Department of Neurosurgery, Medical School, Federal University of Paraná, Curitiba, BRA.
Cureus. 2023 Jun 1;15(6):e39815. doi: 10.7759/cureus.39815. eCollection 2023 Jun.
Spinal epidural abscess is a relatively infrequent surgical indication, but it may be neurologically compromising. The most frequent pathogen is , present in two-thirds of the cases. is part of the intestinal flora and is uncommon in this condition. Colorectal cancer is reported to be a cause of hematogenic translocation and distant infection. We present a case of an 82-year-old patient admitted for acute low back pain with increased inflammatory markers and negative blood cultures. An MRI revealed an epidural lumbar abscess with adjacent spondylitis. After surgical treatment, was identified, and antibiotics were adjusted accordingly. A colonoscopy revealed colon cancer. This is the first case in the literature of a spinal epidural abscess by as the first manifestation of a newly diagnosed colorectal cancer. When facing a spinal infection caused by atypical intestinal bacteria and no other clear sources, a colonoscopy should be considered.
脊髓硬膜外脓肿是一种相对罕见的手术指征，但可能会导致神经功能受损。最常见的病原体是 ，在三分之二的病例中存在。 是肠道菌群的一部分，在这种情况下并不常见。据报道，结直肠癌是血源性转移和远处感染的一个原因。我们报告一例82岁患者，因急性下背痛入院，炎症指标升高，血培养阴性。磁共振成像显示腰段硬膜外脓肿伴相邻脊柱炎。手术治疗后， 被鉴定出来，并相应调整了抗生素。结肠镜检查发现结肠癌。这是文献中首例以 作为新诊断结直肠癌的首发表现的脊髓硬膜外脓肿病例。当面对由非典型肠道细菌引起且无其他明确来源的脊髓感染时，应考虑进行结肠镜检查。
