Geometry.Net - Health_Conditions: Epidural Abscess

EMedicine - Spinal Epidural Abscess : Article By J Stephen Huff, MD
An introduction to spinal epidural abscess, the clinical features, work up, treatment, medicine and Category Health Conditions and Diseases epidural abscessSpinal epidural abscess A spinal epidural abscess threatens the spinal cord bycompression and also by vascular compromise (see Image 1). If untreated, an
http://www.emedicine.com/NEURO/topic349.htm

Extractions: document.write(''); (advertisement) Home Specialties CME PDA ... Patient Education Articles Images CME Patient Education Advanced Search Link to this site Back to: eMedicine Specialties Neurology Neurological Infections Last Updated: December 14, 2001 Rate this Article Email to a Colleague AUTHOR INFORMATION Section 1 of 11 Author Information Introduction Clinical Differentials ... Bibliography Author: J Stephen Huff, MD , Associate Professor of Emergency Medicine and Neurology, Department of Emergency Medicine, University of Virginia Health System J Stephen Huff, MD, is a member of the following medical societies: American Academy of Emergency Medicine , American Academy of Neurology, American College of Emergency Physicians , and Society for Academic Emergency Medicine Editor(s): Edward Hogan, MD , Chair, Professor, Department of Neurology, Medical University of South Carolina; Francisco Talavera, PharmD, PhD , Senior Pharmacy Editor, Pharmacy, eMedicine; Florian P Thomas, MD, PhD, Drmed , Associate Program Director, Associate Professor, Departments of Neurology, Molecular Virology, Molecular Microbiology, and Immunology, Saint Louis University School of Medicine;
EMedicine - Epidural Abscess : Article By Gopala K Yadavalli, MD
epidural abscess An epidural abscess may be defined as pus in the space betweenthe dura mater of the brain or spinal cord and the overlying bone.
http://www.emedicine.com/med/topic2439.htm

Extractions: (advertisement) Home Specialties CME PDA ... Patient Education Articles Images CME Patient Education Advanced Search Link to this site Back to: eMedicine Specialties Medicine, Ob/Gyn, Psychiatry, and Surgery Infectious Diseases Last Updated: March 1, 2002 Rate this Article Email to a Colleague Synonyms and related keywords: spinal epidural abscess, SEA, intracranial epidural abscess, IEA, increased intracranial pressure, ICP AUTHOR INFORMATION Section 1 of 10 Author Information Introduction Clinical Differentials ... Bibliography Author: Gopala K Yadavalli, MD , Fellow, Department of Internal Medicine, Division of Infectious Diseases, University Hospitals of Cleveland and Case Western Reserve University Coauthor(s): Robert A Salata, MD , Chief and Clinical Program Director of Division of Infectious Diseases, Vice Chair for International Affairs, Professor, Department of Medicine, Case Western Reserve University School of Medicine Gopala K Yadavalli, MD, is a member of the following medical societies: American Society of Transplantation Infectious Diseases Society of America , and Society of Critical Care Medicine Editor(s): Fred A Lopez, MD
Spinal Epidural Abscess A Diagnostic Challenge - April 1, 2002 -
epidural abscess of the spinal column is a rare condition that can be fatal if left untreated.
http://www.aafp.org/afp/20020401/1341.html

Extractions: Louisiana State University Health Sciences Center, Monroe, Louisiana Epidural abscess of the spinal column is a rare condition that can be fatal if left untreated. Risk factors for epidural abscess include immunocompromised states such as diabetes mellitus, alcoholism, cancer, and acquired immunodeficiency syndrome, as well as spinal procedures including epidural anesthesia and spinal surgery. The signs and symptoms of epidural abscess are nonspecific and can range from low back pain to sepsis. The treatment of choice in most patients is surgical decompression followed by four to six weeks of antibiotic therapy. Nonsurgical treatment may be appropriate in selected patients. The most common causative organism in spinal epidural abscess is Staphylococcus aureus. A PDF version of this document is available. Download PDF now (6 pages / 184 KB).
ACP-ASIM - Wisconsin Chapter - Spinal Epidural Abscess
Discussion A spinal epidural abscess is an uncommon condition with an estimated incidence of 0.22.0/10000 hospital
http://www.acponline.org/chapters/wi/associates/99/vignette15.htm

Extractions: The College's Bioterrorism Resource Center includes important new patient care information Annals IM Bookmarks Medline Printer-friendly format ... Email this page Intro Prev Next Last O. Zubic, M.D., M. Mian, M.D., Sinai Samaritan Medical Center, Milwaukee, WI A 44-year-old, white male presented with fever, low back pain, lower extremity weakness and difficulty in urination. He had been seen in the emergency department one-month prior with back pain. During the ensuing two weeks his pain intensified and was followed by weakness and bladder dysfunction. He had previously been in good health. On admission he was noted to have a fever of 102.2F, loss of proprioception, decreased sensation and motor weakness in the lower extremities. Laboratory data revealed a WBC of 15.6 K/UL and ESR of 112 mm/hr. The blood cultures were positive for coagulase positive cocci. MRI of the thoracic spine demonstrated an epidural abscess with destruction of the T-11 - T-12 vertebral bodies and cord compression. Administration of broad-spectrum antibiotic agents was begun and adjusted when cultures identified Staph. aureus. Emergent spinal decompression was performed with cultures confirming Staph. aureus infection. Spinal fusion was also done and as soon as the patient's condition was stable, physical therapy was begun. On three-month follow-ups he regained limited ambulating ability.
Bacterial Epidural Abscess & Diskitis Thoracic Spine
enhancement revealed findings consistent with an epidural abscess. Emergency surgery yielded Staphylococcus aureus
http://www.flash.net/~drrad/tf/121696.htm

Extractions: Numaguchi Y; Rigamonti D; Rothman MI; Sato S; et al. Spinal epidural abscess: evaluation with gadolinium-enhanced MR imaging. Radiographics 1993 May;13(3):545-59; discussion 559-60 UI:93303319 Sandhu FS; Dillon WP. Spinal epidural abscess: evaluation with contrast-enhanced MR imaging. AJNR Am J Neuroradiol 1991 Nov-Dec;12(6):1087-93 UI:92109080 Post MJ; Sze G; Quencer RM; Eismont FJ; et al. Gadolinium-enhanced MR in spinal infection. J Comput Assist Tomogr 1990 Sep-Oct;14(5):721-9 UI:90375690 Erntell M; Holt as S; Norlin K; Dahlquist E; Nilsson-Ehle I. Magnetic resonance imaging in the diagnosis of spinal epidural abscess. Scand J Infect Dis 1988;20(3):323-7 UI:88305246 Sadato N; Numaguchi Y; Rigamonti D; Kodama T; et al. Spinal epidural abscess with gadolinium-enhanced MRI: serial follow- up studies and clinical correlations. Neuroradiology 1994;36(1):44-8 UI:94150850 Liem LK; Rigamonti D; Wolf AL; Robinson WL; et al. Thoracic epidural abscess. J Spinal Disord 1994 Oct;7(5):449-54 UI:95119478 Darouiche RO; Hamill RJ; Greenberg SB; Weathers SW; Musher DM. Bacterial spinal epidural abscess. Review of 43 cases and literature survey. REVIEW ARTICLE: 87 REFS. Medicine (Baltimore) 1992 Nov;71(6):369-85 UI:93061980
Uhrad.com - Pediatric Imaging Teaching Files
uhrad.com Pediatric Imaging Teaching Files Case One - Posterior epidural abscess Click on Images for Enlarged View Clinical History 13 year-old white male presents with a 4-day history of upper thoracic back pain.
http://www.uhrad.com/pedsarc/peds001.htm

Extractions: No significant past medical history. Patient pain confined to the T2 region by exam. Referred to MRI to rule out discitis with possible paraspinal abscess. Findings: T-1 weighted and double echo T-2 weighted sagittal T-1 and gradient echo axial, and contrast-enhanced T- 1 weighted sagittal and axial images of the thoracic spine were obtained. Extensive abnormal collection in the posterior epidural space extending from the cervical region through the lowermost visualized portions of the thoracic spine. The signal is of intermediate on the T-1 and proton density images and of increased signal on the T-2 weighted images. Subsequent to the injection of gadolinium, there is enhancement of the dura as well as peripheral enhancement surrounding this collection. However, there is no evidence of spinal cord enhancement. There are multiple strands of epidural fat extending through the aforementioned enhancing fluid collection with a loculated appearance. At multiple levels the fluid collection appears to extend into the left neural foramina. The signal intrinsically within the cord, vertebral bodies, and disc spaces are all normal. Diagnosis: Extensive posterior epidural abscess. This was confirmed surgically with 35 cc of pus removed.
The Epidural Abscess:Diagnosis And Treatment
The epidural abscessDiagnosis and treatment Andre van Zundert, MD, PhD. Catharina Hospital Eindhoven The Netherlands Incidence Most epidural abscesses do occur spontaneously, in normally healthy persons and in all kinds of patients. It can be seen
http://www.esraeurope.org/abstracts/abstracts2000/zundert2.htm

Extractions: The Netherlands Incidence Most epidural abscesses do occur spontaneously, in normally healthy persons and in all kinds of patients. It can be seen even without any form of anaesthesia. All doctors can be confronted with the development of an epidural abscess, which if not noticed, can lead to desastrous consequences. Epidural abscesses can develop in patients who undergo an operation under general anaesthesia, spinal, epidural or combined spinal-epidural anesthesia. Epidural anaesthesia is a worldwide used valuable technique, which is very safe with few neurologic complications. Temporary (transient neurologic symptoms) or permanent sensory and motor dysfunction (sfincter incontinency, paresis and paraplegia) are known to occur. Only in exceptional cases we see permanent devastating neurologic damage. All levels can be affected with an epidural infection, and its location can be in the anterior, posterior or lateral epidural space. Sometimes extensive abscesses can be found which extent from the cervical till the lumbar epidural space. All ages can be affected, including the very young and the aged patients. Epidural abscesses can be found after operative interventions, in the postoperative period, in obstetrics and in pain clinics, where sometimes the pain due to the development of the epidural abscess is blurred by the original pain problem. Epidural abscesses may even develop days to weeks after removal of the epidural catheter. The long delay between the epidural catheter removal and the development of epidural absceses may cause a delay in the diagnosis. The relationship with epidural anesthesia has frequently been unnoticed if this delay is too long (sometimes several months). Sometimes the diagnosis is difficult or delayed when antibiotics are used as prophylacticum during operations or in the postoperative period. Signs and symptoms of infections are delayed or not noticed at all.
CUMC Courseware
the initial presenting symptoms of an acute epidural abscess is often mistaken for another illness and appropriate
http://edcenter.med.cornell.edu/Pathophysiology_Cases/CNS/CNS_07.html

Extractions: Advanced Search by Dr. Richard B. Roberts A 55 y.o. previously healthy male first noted neck pain with radiation down the left arm three days prior to admission (PTA) and was given Motrin for a "pinched nerve." Two days PTA he first noted fever; the pain radiated down both arms and he was given narcotic analgesics for herpes zoster. One day PTA he noted numbness of both legs, progressive weakness of both legs and arms, and difficulty breathing; Guillain-Barre syndrome was entertained. Physical findings on admission revealed cervical spine tenderness, paresis of both arms and legs (quadriplegia), decreased sensory level below T2, and absent deep tendon reflexes. Cervical spine films were negative. CSF had 89 WBC with 93% neutrophils, protein 456 mg%, glucose 30 mg%, and negative Gram stain and cultures. What is the most likely diagnosis?
Med Help
A description of epidural abscess.
http://medhlp.netusa.net/glossary/new/gls_1722.htm
MEDLINEplus Medical Encyclopedia: Epidural Abscess
epidural abscess. epidural abscess is a rare disorder. Nine out often cases are located in the spine (spinal epidural abscess).
http://www.nlm.nih.gov/medlineplus/ency/article/001416.htm

Extractions: Skip navigation Other encyclopedia topics: A-Ag Ah-Ap Aq-Az B-Bk ... Z Contents of this page: Alternative names Abscess - epidural Definition Return to top An inflammation including a collection of infected material (pus) between the dura (the outer membrane covering of the brain and spinal cord), and the bones of the skull or spine. Causes, incidence, and risk factors Return to top Epidural abscess is caused by infection in the area between the bones of the skull or spine, and the outer meninges (the membranes covering the brain and spinal cord). This infection is classified as intracranial epidural abscess if it is located in the skull area, or as a spinal epidural abscess if it is found in the spine area. The infection is usually caused by bacteria ( staphylococcus is common), but some may be caused by fungus. Infected material (pus) frequently includes destroyed tissue cells, white blood cells, and live or dead microorganisms which may wall off into an abscess. There is often inflammation of the tissues around the abscess in response to the infection.
MEDLINEplus Medical Encyclopedia: Spinal Cord Abscess
An abscess of the spinal cord itself is very, very rare. A spinal abscess usuallyoccurs as spinal epidural abscess. A CT scan or MRI confirm epidural abscess.
http://www.nlm.nih.gov/medlineplus/ency/article/001405.htm

Extractions: Skip navigation Other encyclopedia topics: A-Ag Ah-Ap Aq-Az B-Bk ... Z Contents of this page: Central nervous system Alternative names Return to top Abscess - spinal cord Definition Return to top A disorder characterized by inflammation and a collection of infected material (pus) around the spinal cord. Causes, incidence, and risk factors Return to top A spinal cord abscess is caused when infection occurs within the internal areas of the spine. An abscess of the spinal cord itself is very, very rare. A spinal abscess usually occurs as spinal epidural abscess . Pus forms as a collection of fluid, destroyed tissue cells, white blood cells, and live and dead microorganisms. The pus commonly becomes encapsulated (enclosed) by a lining or membrane that forms around the edges. The pus collection ( abscess ) causes pressure on the spinal cord. The infection may cause inflammation and swelling , which also compresses the spinal cord.
EPIDURAL ABSCESS
A description of epidural abscess.Category Health Conditions and Diseases epidural abscessepidural abscess This is a disorder which is characterized by inflammation anda collection of infected material (pus) in the area between the skull bone and
http://www.medhelp.org/glossary/new/gls_1722.htm

Extractions: EPIDURAL ABSCESS - This is a disorder which is characterized by inflammation and a collection of infected material ( pus ) in the area between the skull bone and the covering of the brain ( meninges Infection is usually caused by bacteria Staphylococcus ), but may be secondary to a fungal or viral infection Epidural abscess can occur secondary to a chronic ear or sinus infection, penetrating head injury , or mastoiditis Fever , headache, and neurologic symptoms are common.
Epidural Abscess
Subject epidural abscess Topic Area Neurology General Forum The Neurologyand Neurosurgery Forum Question Posted By New on Friday, March 30, 2001 I
http://www.medhelp.org/forums/neuro/messages/31153a.html

Extractions: I delivered my first baby on Sept. 4, 2000 with the assistance of an epidural. The site where the injection was made then swelled, was red and by 7 days later, started draining pus. I immediately went to the doctor where I was sent to the hospital and the abscess was lanced and drained. I was seen in the emergency room the following night where it was once again lanced. This was left open to drain for approx. 6 weeks. I also might add that this was the most painful experience I have ever had. Now, six months later, I have numbness on my right leg from the knee down and when I sit for prolonged periods of time and go to get up, the tops of my feet feel like someone is stabbing them with a knife and it takes me a few minutes to be able to walk. I just recently had another MRI which showed no abscess present but a mild broad based disc bulge at L3-4 and L4-5. Could this be related to the abscess? I had an MRI about two days after the site was lanced the first time since they were concerned about meningitis.
ThirdAge - Adam - Epidural Abscess
epidural abscess. Definition epidural abscess is a rare disorder. Nineout of ten cases are located in the spine (spinal epidural abscess).
http://www.thirdage.com/health/adam/ency/article/001416.htm

Extractions: document.write(''); document.write(''); document.write(''); document.write(''); document.write(''); document.write(''); document.write(''); document.write(''); Activities Computers Family Tree Health ... Prevention Definition: An inflammation including a collection of infected material (pus) between the dura (the outer membrane covering of the brain and spinal cord), and the bones of the skull or spine. Causes, incidence, and risk factors: Epidural abscess is caused by infection in the area between the bones of the skull or spine, and the outer meninges (the membranes covering the brain and spinal cord). This infection is classified as intracranial epidural abscess if it is located in the skull area, or as a spinal epidural abscess if it is found in the spine area. The infection is usually caused by bacteria ( staphylococcus is common), but some may be caused by fungus. Infected material (pus) frequently includes destroyed tissue cells, white blood cells, and live or dead microorganisms which may wall off into an abscess. There is often inflammation of the tissues around the
Canadian Journal Of Neurological Sciences - Article
Update of spinal epidural abscess 35 cases and review of the literature.
http://cjns.metapress.com/openurl.asp?genre=article&issn=0317-1671&volume=28&iss
Florida State University College Of Medicine Digital Library
epidural abscess Patient/Family Resources. Miscellaneous. Miscellaneous EpiduralAbscess Patient Family Resources Healthfinder (US DHHS) Homepage
http://fsumed-dl.slis.ua.edu/patientinfo/infectious/bybodysystem/cns/epiduralabs

Extractions: Patient/Family Resources by Topic: Infectious Diseases Epidural Abscess Patient/Family Resources Spanish Miscellaneous See also: Spanish Miscellaneous Epidural Abscess Patient Family Resources National Library of Medicine Medline plus Health Topics: List of topics YAHOO - Health:Diseases and Conditions:Infectious Diseases
Florida State University College Of Medicine Digital Library
epidural abscess Clinical Resources. Miscellaneous epidural abscess Clinical ResourcesHealth Reviews for Primary Care Providers on the Internet Homepage
http://fsumed-dl.slis.ua.edu/clinical/infectious/bybodysystem/cns/epiduralabsces

Extractions: Clinical Resources by Topic: Infectious Diseases Epidural Abscess Clinical Resources Emergency Pediatrics Radiology Pathology ... Miscellaneous Resources See also: Causes of Back Pain: Access document Chapter 372: Bacterial Meningitis and Other Suppurative Infections Table of contents Mandell: Principles and Practice of Infectious Diseases 5th Ed.-2000 (MD Consult): Table of contents Medical Library subscription INFO Chapter 70 - Approach to the Patient with Central Nervous System Infection Access document Common Clinical Manifestations Suggesting Central Nervous System Infection Access document Anatomic Relationships of the Brain and Spinal Cord Access document Role of the Intracranial Circulation in Central Nervous System Infections Access document Role of the Cerebrospinal Fluid Circulation in Central Nervous System Infections Access document Routes of Entry into the Central Nervous System by
1Up Health > Epidural Abscess > Causes, Incidence, And Risk Factors Of Epidural
Comprehesive information on epidural abscess (Abscess epidural). 1Up Health Diseases Conditions epidural abscess Causes, Incidence, and Risk Factors.
http://www.1uphealth.com/health/epidural_abscess_info.html

Extractions: 1Up Health Epidural abscess Alternative Medicine Clinical Trials ... Health Topics A-Z Search 1Up Health Epidural abscess Information Epidural abscess Causes, Incidence, and Risk Factors Alternative names : Abscess - epidural Definition : An inflammation including a collection of infected material (pus) between the dura (the outer membrane covering of the brain and spinal cord), and the bones of the skull or spine. Epidural abscess is caused by infection in the area between the bones of the skull or spine, and the outer meninges (the membranes covering the brain and spinal cord). This infection is classified as intracranial epidural abscess if it is located in the skull area, or as a spinal epidural abscess if it is found in the spine area. The infection is usually caused by bacteria ( staphylococcus is common), but some may be caused by fungus. Infected material (pus) frequently includes destroyed tissue cells, white blood cells, and live or dead microorganisms which may wall off into an abscess. There is often inflammation of the tissues around the abscess in response to the infection.
1Up Health > Epidural Abscess (Abscess - Epidural) Information
Comprehesive information on epidural abscess (Abscess epidural). Covers more.1Up Health Diseases Conditions epidural abscess.
http://www.1uphealth.com/health/epidural_abscess.html

Extractions: 1Up Health Alternative Medicine Clinical Trials Health News ... Health Topics A-Z Search 1Up Health Epidural abscess Information Guide Alternative names : Abscess - epidural Definition : An inflammation including a collection of infected material (pus) between the dura (the outer membrane covering of the brain and spinal cord), and the bones of the skull or spine. A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is the first of its kind, requiring compliance with 53 standards of quality and accountability, verified by independent audit. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial reviewers . A.D.A.M. is also a founding member of Hi-Ethics (www.hiethics.com) and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).
THE MERCK MANUAL, Sec. 14, Ch. 182, Spinal Cord Disorders
General. Spinal Cord Compression. Subdural Or epidural abscess And Hematoma.Syrinx. click here for navigation help. Subdural Or epidural abscess And Hematoma.
http://www.merck.com/pubs/mmanual/section14/chapter182/182c.htm

Extractions: This Publication Is Searchable The Merck Manual of Diagnosis and Therapy Section 14. Neurologic Disorders Chapter 182. Spinal Cord Disorders Topics [General] Spinal Cord Compression Subdural Or Epidural Abscess And Hematoma Syrinx ... Spinal Cord Injury Subdural Or Epidural Abscess And Hematoma Spinal subdural or epidural abscess often occurs in a patient with an underlying infection, either remote (eg, furuncle, dental abscess) or contiguous (eg, vertebral osteomyelitis, decubitus ulcer, retroperitoneal abscess). About 1/3 of cases arise spontaneously, without the cause becoming apparent. The most common causative organism is Staphylococcus aureus, followed by Escherichia coli and mixed anaerobes. Rarely, a tuberculous abscess accompanies Pott's disease of the thoracic spine. Spinal subdural or epidural hematoma may result from back trauma, from anticoagulant or thrombolytic therapy, or, in patients with bleeding diathesis, from lumbar puncture. Spinal abscess and hematoma begin with local back pain and percussion tenderness (usually thoracic or lumbar) that are often severe; pain may radiate in a root distribution. Compression of the cord or lumbar spinal roots leads to weakness in a cauda equina, paraplegic, or quadriplegic pattern. With abscess, weakness initially progresses over hours to days, often abruptly deteriorating to paraplegia or quadriplegia; with hematoma, weakness usually progresses within minutes to several hours. Whether sensory or sphincter deficits occur depends on the site and size of the lesion. Most patients with an abscess are febrile, and CSF has a high protein content and lymphocytic pleocytosis; spinal x-rays show osteomyelitic findings in about 1/3 of cases.

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