title: Spinal subdural abscess: a rare complication of decubitus ulcer.
abstract: Spinal subdural abscess (SSA) is an uncommon entity. The exact incidence is unknown, with very few cases reported in the literature. This condition may result in spinal cord compression, thus constituting a medical and neurosurgical emergency. The pathogenesis of SSA is not well-described, and the available knowledge is based on case observations only. There is only one case report that describes direct seeding from decubitus ulcers as a possible mechanism for development of SSA. We report a case of subacute onset of quadriplegia in a male patient, age 55 years, due to spinal cord compression from SSA and superimposed spinal subdural hematoma. The direct seeding from decubitus ulcers is thought to be the cause of infection in our patient. We present this case of SSA to elucidate and review the predisposing factors, pathogenesis, clinical presentation, diagnostic modalities, and treatment regarding management of this rare disorder.
authors.affiliation: Department of Internal Medicine, Marshfield Clinic, Marshfield, Wisconsin, USA nusolts@gmail.com.
authors.forename: Natalia
authors.initials: N
authors.lastname: Usoltseva
authors.affiliation: Lab-Pathology, Marshfield Clinic, Marshfield, Wisconsin, USA.
authors.forename: Rafael
authors.initials: R
authors.lastname: Medina-Flores
authors.affiliation: Hospital Medicine, Marshfield Clinic, Marshfield, Wisconsin, USA.
authors.forename: Ateeq
authors.initials: A
authors.lastname: Rehman
authors.affiliation: Department of Internal Medicine, Marshfield Clinic, Marshfield, Wisconsin, USA.
authors.forename: Swetha
authors.initials: S
authors.lastname: Samji
authors.affiliation: Department of Internal Medicine, Marshfield Clinic, Marshfield, Wisconsin, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: D'Costa
mesh_terms: D000038:Abscess / Q000209:etiology*; D013354:Empyema, Subdural / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009187:Myelitis / Q000209:etiology*; D010264:Paraplegia / Q000150:complications; D003668:Pressure Ulcer / Q000150:complications*; D013119:Spinal Cord Injuries / Q000150:complications
keywords: Abscess/complications; Bacteroides infections/complications; Empyema; Spinal cord injury/complications; Subdural abscess; subdural/diagnosis/microbiology