Cervical discitis associated with spinal epidural abscess caused by methicillin-resistant staphylococcus aureus.
A 53-year-old male developed fever, nuchalgia, shoulder pain, and sore throat after a partial sigmoidectomy. He suffered sudden onset of quadriplegia about 5 days later. Magnetic resonance (MR) imaging indicated the characteristic appearance of C5-6 intervertebral disc herniation. However, anterior discectomy showed that he had cervical discitis associated with spinal epidural abscess. Continuous pus drainage from the abscess and vigorous antibiotic therapy were undertaken after surgery. He improved and could walk with assistance. MR imaging with gadolinium can be useful in diagnosing pyogenic spinal infection (epidural abscess, osteomyelitis, and discitis), but care should be taken in MR image interpretation since spinal epidural abscess associated with discitis may mimic disc herniation. Axial MR images are important to distinguish this rare disease from other cervical disorders.
Sawada
M
M
Department of Neurosurgery, Matsunami General Hospital, Gifu.
Iwamura
M
M
Hirata
T
T
Sakai
N
N
D000038:Abscess / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002574:Cervical Vertebrae / Q000503:physiopathology*; D015299:Discitis / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008712:Methicillin / Q000627:therapeutic use*; D016106:Methicillin Resistance; D008875:Middle Aged; D013116:Spinal Cord / Q000382:microbiology* / Q000503:physiopathology; D013211:Staphylococcus aureus / Q000302:isolation & purification* / Q000472:pathogenicity*; D014057:Tomography, X-Ray Computed
D000900:Anti-Bacterial Agents; D008712:Methicillin