title: Acute spinal epidural abscess without concurrent spondylodiscitis. Successful closed treatment in 10 cases.
abstract: We performed a retrospective survey of the clinical records and radiological examinations of 10 patients with a diagnosis of spinal epidural abscess, without spondylodiscitis. All patients had an acute onset of fever and local or radiating back pain. 3 patients had mild, and 1 patient severe neurological symptoms. The diagnosis and subsequent regression of the abscess after treatment were verified by MRI. In all cases, the imaging findings included signs of septic arthritis in an adjoining facet joint. 7/10 abscesses were located in the lumbar region. Blood cultures showed Staphylococcus aureus as the etiological agent in 8/10 patients. In 2 cases, no agent was found, probably due to ongoing antibiotic therapy when the cultures were taken. All patients were treated successfully using antibiotics alone, with complete regression of the neurological symptoms.
authors.affiliation: Department of Orthopaedics, Karolinska Institute, Danderyd Hospital, Sweden. torbjorn.ahl@ort.ds.sll.se
authors.forename: T
authors.initials: T
authors.lastname: Ahl
authors.forename: M
authors.initials: M
authors.lastname: Hedström
authors.forename: A
authors.initials: A
authors.lastname: von Heijne
authors.forename: S
authors.initials: S
authors.lastname: Hammers Stiernstedt
mesh_terms: D000038:Abscess / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D000208:Acute Disease; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001416:Back Pain / Q000382:microbiology; D015299:Discitis / Q000150:complications*; D004824:Epidural Space; D005260:Female; D005334:Fever / Q000382:microbiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D013122:Spinal Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D013203:Staphylococcal Infections / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D013211:Staphylococcus aureus; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents