Infectious epiduritis and epidural abscesses are relatively rare pathologies but with important neurological consequences. A low incidence associated with an insidious clinical presentation leads to frequent delays in diagnosis, which worsen the prognosis of patients with the development of neurological deficits. While the evaluation of risk factors, a careful clinical examination and biological tests can guide to the diagnosis, the key examination remains magnetic resonance imaging (MRI) while lumbar puncture remains contraindicated. Although surgery (spinal decompression) has long been the treatment of choice, the current management of patients with infectious epiduritis is debated between surgery and conservative treatment with systemic antibiotic therapy.
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Cureus
December 2024
Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, USA.
Pyogenic spinal infections due to ()are rare. After a search of the literature, we deemed our case to be the first description of spinal epidural abscess (SEA) from . This is a 74-year-old female patient with a history of diabetes who presented to the emergency department with fever and persistent paracervical pain after being initially diagnosed with viral sinusitis two days prior.
View Article and Find Full Text PDFBMC Infect Dis
December 2024
Department of Orthopedics, Leshan People's Hospital, No. 238 Baita Street, Shizhong District, Leshan, Sichuan Province, China.
Background: Fungal spondylitis often occurs in patients with immune dysfunction, and its diagnosis and treatment pose certain challenges. However, even in immunocompromised patients, Aspergillus spondylitis remains rare. This case reports the diagnostic and therapeutic experience of fungal spondylitis in a patient with consolidated cirrhosis and no significant immune impairment.
View Article and Find Full Text PDFJ Pediatric Infect Dis Soc
December 2024
University of Washington School of Medicine, Department of Pediatrics, Division of Infectious Diseases, Seattle, WA, USA.
A survey of pediatric infectious diseases clinicians from 49 children's hospitals demonstrated variability across institutions in the treatment of epidural empyema from sinus extension, including antibiotic route, selection, and impact of neuroimaging on determining duration of therapy.
View Article and Find Full Text PDFSpine J
December 2024
Department of Neurosurgery, University Medical Center Mainz, Mainz, Germany.
Background Context: Spondylodiscitis management presents significant clinical challenges, particularly in critically ill patients, where the risks and benefits of surgical intervention must be carefully balanced. The optimal timing of surgery in this context remains a subject of debate.
Purpose: This study aims to evaluate the effectiveness of early surgery versus delayed surgery or conservative management in critically ill patients with de novo pyogenic spondylodiscitis.
Objective: Spinal epidural abscesses (SEAs) are rare infections in children but can lead to significant neurological sequelae. The authors sought to describe the presentation, management, and outcomes of children with these infections at their institution.
Methods: This was a retrospective study of pediatric patients admitted with SEA to a quaternary children's hospital between 2013 and 2023.
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