[Diagnosis of acute infectious epidural inflammation. Role of magnetic resonance imaging].
External pachymeningitis, usually caused by Staphylococcus aureus, is a rare pathological entity which is difficult to diagnose at an early stage, has a poor functional prognosis and often requires an emergency surgical treatment. We report three cases in which magnetic resonance imaging provided an early diagnosis of the epidural space infection before severe neurological deficits, such as paraparesis and/or paraplegia, set in. Following an anti-staphylococcal treatment with fluoroquinolone and beta-lactamase-resistant beta-lactam antibiotics with good bone penetration administered intravenously during 4 to 6 weeks, then orally for 5 to 6 months cure without functional sequelae was obtained in all three patients.
Service des Maladies infectieuses et Pathologies tropicales, Hôpital de la Croix Rousse, Lyon.
J P
JP
Claudel
F
F
Biron
A
A
Boibieux
D
D
Bossard
C
C
Allimand
D
D
Peyramond
D000208:Acute Disease; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004824:Epidural Space; D005260:Female; D006801:Humans; D007249:Inflammation / Q000175:diagnosis* / Q000188:drug therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000188:drug therapy
D000900:Anti-Bacterial Agents
Diagnostic des épidurites aiguës infectieuses. Place de l'imagerie par résonance magnétique.