Spinal epidural empyema

Spinal epidural empyema is a very rare entity occurring with an estimated incidence of 1 per 10,000 hospital admissions. This condition has a reputation for presenting as a diagnostic challenge resulting in late diagnosis and delayed treatment. However, the cornerstones of treatment are prompt diagn...

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Bibliographic Details
Published in:British journal of neurosurgery 2003-04, Vol.17 (2), p.196-200
Main Authors: Pilkington, S. A., Jackson, S. A., Gillett, G. R.
Format: Article
Language:English
Subjects:
Abscess
Adult
Aged
Antibiotics
Bacterial diseases
Bacterial diseases of the nervous system. Bacterial myositis
Biological and medical sciences
Empyema - diagnosis
Empyema - microbiology
Empyema - therapy
Epidural Abscess - diagnosis
Epidural Abscess - microbiology
Epidural Abscess - therapy
Epidural Empyema
Female
Gadolinium
Gadolinium-enhanced
Human bacterial diseases
Humans
Infectious diseases
Intraspinal Abscess
Lumbar Puncture
Magnetic Resonance Imaging - methods
Male
Medical diagnosis
Medical sciences
Medical treatment
Middle Aged
Mri
Neurology
Pyrexia
Risk Factors
Spinal cord
Spinal Cord Compression
Spinal Cord Compression - microbiology
Spinal Cord Compression - surgery
Spinal Cord Diseases - diagnosis
Spinal Cord Diseases - microbiology
Spinal Cord Diseases - therapy
Spinal Pain
Staphylococcal Infections - diagnosis
Staphylococcal Infections - therapy
Staphylococcus Aureus
Staphylococcus aureus - isolation & purification
Surgery
Tropical medicine
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Description
Summary:Spinal epidural empyema is a very rare entity occurring with an estimated incidence of 1 per 10,000 hospital admissions. This condition has a reputation for presenting as a diagnostic challenge resulting in late diagnosis and delayed treatment. However, the cornerstones of treatment are prompt diagnosis and early treatment to prevent permanent paralysis and high mortality. We present a cluster of nine cases presenting to the neurosurgery unit over a 3-year period and discuss their relevant features in view of the most recent literature. The diagnosis of spinal epidural empyema was made with gadolinium-enhanced MRI in eight of nine cases. Staphylococcus aureus was isolated as the causative pathogen in all cases. All patients were treated with antibiotics. Eight patients had surgery for debridement and spinal decompression. One patient was treated successfully with antibiotics alone.
ISSN:0268-8697
1360-046X
DOI:10.1080/0268869031000108990