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Nery B, Filho CB, Nunes L, Quaggio E, Filho FB, Neto JA, Melo LR, Oliveira AC, Rabello R, Durand VR, Silva RR, Costa RE, Segundo JA. Acute Paraplegia Caused by Spinal Epidural Empyema Following Infectious Cellulitis of the Hand: Case Report and Literature Review. J Neurol Surg Rep 2024; 85:e29-e38. [PMID: 38596232 PMCID: PMC11001457 DOI: 10.1055/a-2267-1810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 01/14/2024] [Indexed: 04/11/2024] Open
Abstract
Background Spinal epidural abscess is a rare but serious condition that can cause spinal cord compression and neurological deficits. Case Description and Methods 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." Conclusion 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.
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Affiliation(s)
- Breno Nery
- Department of Neurosurgery, Hospital Beneficiência Portuguesa de Ribeirão Preto, Ribeirão Preto, SP, Brazil
| | - Cláudio Brandão Filho
- Department of Neurosurgery, Hospital Beneficiência Portuguesa de Ribeirão Preto, Ribeirão Preto, SP, Brazil
- Department of Neurosurgery, Universitary Center Unifacisa, Campina Grande, Paraíba, Brazil
| | - Lucas Nunes
- Department of Neurosurgery, Hospital Beneficiência Portuguesa de Ribeirão Preto, Ribeirão Preto, SP, Brazil
| | - Eduardo Quaggio
- Department of Neurosurgery, Hospital Beneficiência Portuguesa de Ribeirão Preto, Ribeirão Preto, SP, Brazil
| | - Fred Bernardes Filho
- Department of Neurosurgery, Hospital Beneficiência Portuguesa de Ribeirão Preto, Ribeirão Preto, SP, Brazil
| | - Joaquim Alencar Neto
- Department of Neurosurgery, Hospital Beneficiência Portuguesa de Ribeirão Preto, Ribeirão Preto, SP, Brazil
| | - Layssa Rhossana Melo
- Department of Neurosurgery, Hospital Beneficiência Portuguesa de Ribeirão Preto, Ribeirão Preto, SP, Brazil
| | - Anna Carolyne Oliveira
- Department of Neurosurgery, Hospital Beneficiência Portuguesa de Ribeirão Preto, Ribeirão Preto, SP, Brazil
| | - Rafael Rabello
- Department of Neurosurgery, Hospital Beneficiência Portuguesa de Ribeirão Preto, Ribeirão Preto, SP, Brazil
| | - Victoria Rodrigues Durand
- Department of Neurosurgery, Hospital Beneficiência Portuguesa de Ribeirão Preto, Ribeirão Preto, SP, Brazil
| | - Rayssa Rocha Silva
- Department of Neurosurgery, Hospital Beneficiência Portuguesa de Ribeirão Preto, Ribeirão Preto, SP, Brazil
| | - Rafael Emmanuel Costa
- Department of Neurosurgery, Hospital Beneficiência Portuguesa de Ribeirão Preto, Ribeirão Preto, SP, Brazil
| | - José Alencar Segundo
- Department of Neurosurgery, Hospital Beneficiência Portuguesa de Ribeirão Preto, Ribeirão Preto, SP, Brazil
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Munasinghe BM, Pathirage N, Hameed MS, Hapuarachchi CT. Pus in Spinal Needle: Diagnosis and Management of a Long-Segment Spinal Epidural Abscess. Case Rep Infect Dis 2021; 2021:9989847. [PMID: 34007497 DOI: 10.1155/2021/9989847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/05/2021] [Accepted: 04/16/2021] [Indexed: 11/21/2022] Open
Abstract
Spinal-epidural abscess (SEA) is believed to be primarily of haematogenous origin and very rarely as a consequence of central neuraxial blockade. Early diagnosis and pertinent management invariably improve neurological outcomes. We report a case of long-segment SEA, which was suspected during subarachnoid anaesthesia, subsequently diagnosed and managed appropriately, averting irreversible neurological deficits.
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