Pan-spinal Epidural Abscess in a Diabetic Patient
نویسندگان
چکیده
A 62-year-old man visited our emergency department with sudden onset of paraparesis 24 hours before the visit. His medical history revealed prolonged suffering from back pain in addition to diabetes mellitus for 27 years. T2weighted-magnetic resonance imaging of the spine revealed epidural space lesions that extended from C5 to L5 and occupied posterior spaces (Picture 1, 2). The patient was diagnosed with pan-spinal epidural abscess (pan-SEA) and underwent laminectomy from C4 to L1 and drainage. Blood and abscess cultures revealed a methicillin-sensitive Staphylococcus aureus infection. Despite the administration of systemic antibiotics in addition to surgery, the paralysis of the legs did not completely subside. SEA often leads to neurologic deterioration, sepsis, and death without early intervention (1). No randomized studies have investigated the outcomes of surgical treatment of pan-SEA for which decompressive laminectomy and drainage are not recommended (2). This case emphasizes the difficulty in treating pan-SEA.
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