Acute spinal epidural abscess and spinal leptomeningitis: report of 2 cases with comparative neuroradiological and autopsy study.
A 21-year-old male developed back pain, fever, and rapidly progressive quadriparesis. Lumbar tap yielded frank pus which was confirmed on magnetic resonance imaging (MRI) to be located mainly in the cervical epidural space. Conservative antibiotic remedy was partially effective for restoration of the neurological deficits. A 82-year-old female noticed low-back pain which was rapidly accompanied with clouding of consciousness, paraplegia, and sphincter disturbances. Lumbar puncture revealed thick pus which was best depicted on MRI in the thoracolumbar subarachnoid space. At autopsy, spinal subarachnoid abscess or leptomeningitis was confirmed, and a spinal infarction previously unrecognized on MRI was found. Usefulness and shortcomings of MRI in the diagnosis of paraspinal infections are discussed.
Fukui
T
T
Department of Neurology, Showa University School of Medicine, Tokyo, Japan.
Ichikawa
H
H
Kawate
N
N
Nozawa
T
T
Sugita
K
K
D000038:Abscess / Q000175:diagnosis* / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001100:Arachnoiditis / Q000175:diagnosis* / Q000473:pathology; D003287:Contrast Media; D004824:Epidural Space; D004927:Escherichia coli Infections / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009192:Myelography; D009460:Neurologic Examination; D009942:Organometallic Compounds; D004369:Pentetic Acid; D013116:Spinal Cord / Q000473:pathology; D013117:Spinal Cord Compression / Q000175:diagnosis / Q000473:pathology; D013122:Spinal Diseases / Q000175:diagnosis* / Q000473:pathology; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000473:pathology; D013346:Subarachnoid Space
D003287:Contrast Media; D009942:Organometallic Compounds; D004369:Pentetic Acid; D019786:Gadolinium DTPA