title: Rapidly progressive paraplegia and pleural empyema: how does that correlate?
abstract: A 74-year-old man presented with progressive dyspnea after a 10-days latency following a thoracic trauma. CT imaging showed multiple rib fracture and an empyema that was primarily treated by a chest tube. In the course of the hospital stay, a rapidly progressive paraplegia developed and the MR imaging revealed a peridural abscess caused by a pleural empyema. Due to trauma-related barrier damage and the initial delay of the operative therapy a usually less invasive pathogen (streptococcus intermedius) could affect the peridural space. The successful therapy consisted of urgent laminectomy and a subsequent video-assisted thoracoscopy supported by systemic antibiotic therapy.
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, Tuebingen University Hospital, Hoppe-Seyler-Straße 3, 72076, Tuebingen, Germany, mariolescan@gmx.de.
authors.forename: Mario
authors.initials: M
authors.lastname: Lescan
authors.forename: Guilherme
authors.initials: G
authors.lastname: Lepski
authors.forename: Volker
authors.initials: V
authors.lastname: Steger
authors.forename: Christian
authors.initials: C
authors.lastname: Schlensak
authors.forename: Tobias
authors.initials: T
authors.lastname: Walker
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015505:Chest Tubes; D016724:Empyema, Pleural / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D020802:Epidural Abscess / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007796:Laminectomy; D008279:Magnetic Resonance Imaging; D008297:Male; D010264:Paraplegia / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D013898:Thoracic Injuries / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D020775:Thoracic Surgery, Video-Assisted
chemical_list: D000900:Anti-Bacterial Agents