Pneumorrhachis Secondary to Klebsiella pneumoniae Gas-Forming Paraspinal Abscess: A Case report and Review of Literature

Pneumorrhachis is a rare entity, where air pockets are found in the spinal canal and the etiology can be categorized into traumatic and non-traumatic, the latter further categorized into spontaneous, iatrogenic, and associated with infections. Infective causes are often associated with gas-forming o...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2023-09, Vol.15 (9)
Main Authors: Sumitro, Kosasih, Basir, Dewi Norwani, Metussin, Adli, Lim, Kian Chai, Chong, Vui Heng
Format: Article
Language:English
Subjects:
Abdomen
Abscesses
Antibiotics
Bacteria
Case reports
COVID-19
Emphysema
Epidural
Fistula
Gastroenterology
Hepatitis C
Iatrogenesis
Infections
Infectious Disease
Influenza
Internal Medicine
Liver cirrhosis
Medical imaging
Meningitis
Organisms
Prostate
Respiratory syncytial virus
Severe acute respiratory syndrome coronavirus 2
Viruses
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Summary:Pneumorrhachis is a rare entity, where air pockets are found in the spinal canal and the etiology can be categorized into traumatic and non-traumatic, the latter further categorized into spontaneous, iatrogenic, and associated with infections. Infective causes are often associated with gas-forming organisms and are associated with significant morbidity and mortality. Often the diagnosis is not suspected until imaging is done. We report the case of a 57-year-old man who presented with fever, backache, lower leg weakness, and dysuria. A computed tomography scan for evaluation of intra-abdominal sepsis incidentally showed pneumorrhachis affecting the thoracic and lumbar levels, gas-forming paraspinal abscess, prostate abscess, liver cirrhosis, and sigmoid colon carcinoma. Blood culture isolated Klebsiella pneumoniae. The patient recovered after six weeks of intravenous antibiotics followed later by sigmoid colectomy and chemotherapy. A literature review identified 63 cases of pneumorrhachis associated with infections and can be categorized into infections with spontaneous pneumorrhachis (predominantly respiratory tract infections), infections with pneumorrhachis (predominantly with emphysematous infections), and iatrogenic with infections and pneumorrhachis (predominantly postspinal interventions). Infections with pneumorrhachis occurred in older age groups and were associated with higher mortality compared to the other two categories.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.45851