Colle I, Peeters P, Le Roy I, Diltoer M, D'Haens J
Department of Internal Medicine, Academisch Ziekenhuis, Vrije Universiteit Brussel (VUB), Belgium.
Acta Clin Belg. 1996;51(6):412-6. doi: 10.1080/22953337.1996.11718540.
Spinal epidural abscess is an uncommon site of infection, resulting in back pain, fever, weakness and loss of sensibility. These signs should suggest the diagnosis, and quick confirmation by MRI should be performed. Immediate surgical decompression and antibiotherapy is necessary, because this is the base of a possible successful functional recovery. Empiric therapy consisting of high dose of penicillinase-resistant antibiotics is advised because most often an epidural abscess is caused by Staphylococcus aureus. However, because other bacteria can be involved, an aminoglycoside or a cephalosporin should be added to the empiric treatment, until the results of the cultures are known. When diagnosis and therapy are delayed, permanent paralysis and death are common.
脊柱硬膜外脓肿是一种少见的感染部位,可导致背痛、发热、乏力和感觉丧失。这些症状应提示诊断,需通过磁共振成像(MRI)迅速确诊。立即进行手术减压和抗生素治疗是必要的,因为这是实现功能成功恢复的基础。建议采用大剂量耐青霉素酶抗生素进行经验性治疗,因为硬膜外脓肿大多由金黄色葡萄球菌引起。然而,由于可能涉及其他细菌,在培养结果出来之前,经验性治疗应添加氨基糖苷类药物或头孢菌素。若诊断和治疗延迟,常出现永久性瘫痪和死亡。