Epidural abscess T5T8 due to methicillin-resistent staphylococcus aureus in an immunocompetent patient.
A 28-year-old man was admitted with severe thoracic pain, a body temperature of 37.20, paraplegia and sphincter disturbances. MRI revealed an epidural abscess T5T8. A decompressive laminectomy T5T8 was performed and the abscess was removed. A methicillin-resistent Staphylococcus aureus was cultured. Vancomycin was administered. Six months later muscle testing showed values from 3/5 to 4/5. MRI is the first choice diagnostic tool. Laminectomy, drainage and intravenous antibiotics constitute the basic treatment. Antibiotics alone can be sufficient in case of whole spine involvement, lumbosacral localization without neurological symptoms, fixed neurological deficit, complete paralysis for more than 72 hours, or severe concomitant medical problems.
Department of Orthopaedic Surgery, Third affiliated Hospital of Wenzhou Medical School, Wenzhou, Zhejiang, China.
He
H
Shaoqi
Lin
L
Lixing
Tang
T
Chengxuan
Yang
Y
Guojing
D000328:Adult; D020802:Epidural Abscess / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D006801:Humans; D007796:Laminectomy; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D013117:Spinal Cord Compression / Q000209:etiology; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D013904:Thoracic Vertebrae