title: Presentation of cauda equina syndrome due to an intradural extramedullary abscess: a case report.
abstract: BACKGROUND
  Cauda equina syndrome is caused by compression or injury to the nerve roots distal to the level of the spinal cord. This syndrome presents as low back pain, motor and sensory deficits in the lower extremities, and bladder as well as bowel dysfunction. Although various etiologies of cauda equina syndrome have been reported, a less common cause is infection.
  
  
  OBJECTIVE
  To report a case of cauda equina syndrome caused by infection of an intradural extramedullary abscess with Staphylococcus aureus.
  
  
  METHODS
  Case report and review of the literature.
  
  
  METHODS
  The literature regarding the infectious causes of cauda equina syndrome was reviewed and a case of cauda equina syndrome caused by infection of an intradural extramedullary abscess with Staphylococcus aureus was reported.
  
  
  RESULTS
  A 37-year-old woman, with history of intravenous drug abuse, hepatitis C, and hepatitis B, presented with low back pain lasting 2 months, lower extremity pain, left greater than right with increasing weakness and difficulty ambulating, and urinary and fecal incontinence. Her presentation was consistent with cauda equina syndrome. The patient underwent a T12-L2 laminectomy, and intradural exploration revealed an abscess. Methicillin-resistant Staphylococcus aureus was found on wound culture.
  
  
  CONCLUSIONS
  Cauda equina syndrome, presenting as a result of spinal infection, such as the case reported here, is extremely rare but clinically important. Surgical intervention is generally the recommended therapeutic modality.
authors: Department of Neurological Surgery, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, 90 Bergen St, Suite 8100, PO Box 1709, Newark, NJ 07101-1709, USA.
authors: Nitin
authors: N
authors: Agarwal
authors: Department of Neurological Surgery, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, 90 Bergen St, Suite 8100, PO Box 1709, Newark, NJ 07101-1709, USA.
authors: Janki
authors: J
authors: Shah
authors: Department of Neurological Surgery, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, 90 Bergen St, Suite 8100, PO Box 1709, Newark, NJ 07101-1709, USA.
authors: David R
authors: DR
authors: Hansberry
authors: Department of Neurological Surgery, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, 90 Bergen St, Suite 8100, PO Box 1709, Newark, NJ 07101-1709, USA.
authors: Antonios
authors: A
authors: Mammis
authors: Department of Neurological Surgery, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, 90 Bergen St, Suite 8100, PO Box 1709, Newark, NJ 07101-1709, USA.
authors: Leroy R
authors: LR
authors: Sharer
authors: Department of Neurological Surgery, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, 90 Bergen St, Suite 8100, PO Box 1709, Newark, NJ 07101-1709, USA. Electronic address: goldstir@umdnj.edu.
authors: Ira M
authors: IM
authors: Goldstein
mesh_terms: D000038:Abscess / Q000150:complications / Q000382:microbiology* / Q000601:surgery; D000328:Adult; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000494:pharmacology; D019299:Decompression, Surgical / Q000379:methods; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007796:Laminectomy / Q000379:methods; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification / Q000472:pathogenicity*; D011128:Polyradiculopathy / Q000209:etiology / Q000601:surgery* / Q000628:therapy; D013118:Spinal Cord Diseases / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D000890:Anti-Infective Agents
keywords: Cauda equina syndrome; Infection; Intradural extramedullary abscess; Staphylococcus aureus