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手部感染性蜂窝织炎后脊髓硬膜外脓肿导致的急性截瘫:病例报告及文献综述

Acute Paraplegia Caused by Spinal Epidural Empyema Following Infectious Cellulitis of the Hand: Case Report and Literature Review.

作者信息

Nery Breno, Filho Cláudio Brandão, Nunes Lucas, Quaggio Eduardo, Filho Fred Bernardes, Neto Joaquim Alencar, Melo Layssa Rhossana, Oliveira Anna Carolyne, Rabello Rafael, Durand Victoria Rodrigues, Silva Rayssa Rocha, Costa Rafael Emmanuel, Segundo José Alencar

机构信息

Department of Neurosurgery, Hospital Beneficiência Portuguesa de Ribeirão Preto, Ribeirão Preto, SP, Brazil.

Department of Neurosurgery, Universitary Center Unifacisa, Campina Grande, Paraíba, Brazil.

出版信息

J Neurol Surg Rep. 2024 Apr 8;85(2):e29-e38. doi: 10.1055/a-2267-1810. eCollection 2024 Apr.

Abstract

Spinal epidural abscess is a rare but serious condition that can cause spinal cord compression and neurological deficits.  The article reports a case of a 31-year-old patient who presented with an infectious cellulitis in the left hand, which progressed to a spinal epidural abscess. The diagnosis was confirmed by clinical examination and magnetic resonance imaging. Treatment involved laminectomy, after which the patient had complete recovery of neurological deficits. This article is a case report with a literature review. Patient data and images were collected by the researchers who participated in the patient's care. The literature was reviewed by one of the researchers based on the search for articles in the PubMed database. For the research, the following keywords were inserted: "Spinal epidural empyema," "Spinal epidural abscess."  Spinal epidural abscess is often underdiagnosed, which can lead to delays in treatment and serious complications. The relationship between cellulitis and spinal epidural abscess may be related to the spread of infection through the lymphatic or blood system.

摘要

脊柱硬膜外脓肿是一种罕见但严重的疾病,可导致脊髓受压和神经功能缺损。本文报道了一例31岁患者,该患者最初表现为左手感染性蜂窝织炎,随后发展为脊柱硬膜外脓肿。通过临床检查和磁共振成像确诊。治疗包括椎板切除术,术后患者神经功能缺损完全恢复。本文是一篇病例报告并附有文献综述。患者数据和图像由参与患者护理的研究人员收集。其中一名研究人员基于在PubMed数据库中搜索文章对文献进行了综述。在该研究中,插入了以下关键词:“脊柱硬膜外积脓”、“脊柱硬膜外脓肿”。脊柱硬膜外脓肿常常被漏诊,这可能导致治疗延误和严重并发症。蜂窝织炎与脊柱硬膜外脓肿之间的关系可能与感染通过淋巴系统或血液系统传播有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4084/11001457/1ada0bd7ac20/10-1055-a-2267-1810-i23jul0016-1.jpg

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引用本文的文献

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本文引用的文献

1
Case Report: A case of cervical spinal epidural abscess combined with cervical paravertebral soft tissue abscess.
Front Surg. 2022 Oct 5;9:967806. doi: 10.3389/fsurg.2022.967806. eCollection 2022.
2
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BMJ Case Rep. 2022 Aug 23;15(8):e250733. doi: 10.1136/bcr-2022-250733.
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spinal epidural abscess: A case report and review of the literature.
J Craniovertebr Junction Spine. 2022 Apr-Jun;13(2):204-211. doi: 10.4103/jcvjs.jcvjs_35_22. Epub 2022 Jun 13.
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IGA nephropathy and spinal epidural abscess after COVID-19 infection: a case report.
Future Virol. 2022 Jun. doi: 10.2217/fvl-2021-0314. Epub 2022 Jun 28.
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Extensive Spinal Epidural Abscess Resulting in Complete Paraplegia Treated by Selective Laminectomies and Irrigation.
Orthop Surg. 2022 Sep;14(9):2380-2385. doi: 10.1111/os.13367. Epub 2022 Jun 22.
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Cureus. 2022 May 4;14(5):e24735. doi: 10.7759/cureus.24735. eCollection 2022 May.
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Surg Neurol Int. 2022 Apr 22;13:159. doi: 10.25259/SNI_260_2022. eCollection 2022.
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Methicillin-Resistant Staphylococcus aureus Spinal Epidural Abscess: Local and Systemic Case Management.
Cureus. 2022 Mar 3;14(3):e22831. doi: 10.7759/cureus.22831. eCollection 2022 Mar.

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