Geometry.Net - Health_Conditions: Epidural Abscess

THE MERCK MANUAL, Sec. 14, Ch. 182, Spinal Cord Disorders
An article about spinal cord compression, its diagnosis and treatment.Category Health Conditions and Diseases Spinal Cord Compression Subdural Or epidural abscess And Hematoma. Syrinx. 177), a subdural or epidural abscessor hematoma (see below), or a cervical (or rarely thoracic) disk rupture.
http://www.merck.com/pubs/mmanual/section14/chapter182/182b.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 Spinal Cord Compression Many diseases affect the spinal cord by mechanical compression, which often presents stereotypically and can be treated effectively if detected early. Acute compression is usually traumatic, producing signs of segmental damage at the level of compression usually combined with corticospinal tract dysfunction (eg, hyperreflexia, Babinski's sign, weakness) and sensory deficits below the level of compression (see Spinal Cord Injury, below). Subacute compression is usually caused by an extramedullary neoplasm (see Spinal Cord Neoplasms in Ch. 177), a subdural or epidural abscess or hematoma (see below ), or a cervical (or rarely thoracic) disk rupture. Patients present with local spinal pain, often with a radicular distribution, and reflex changes due to corticospinal tract dysfunction. Weakness (often proximal) of the legs, sensory loss, and, finally, loss of sphincter control follow. Segmental motor or sensory loss in the arms is common with cervical lesions. Pain and mild weakness may last hours to days, but the transition to total loss of function caudal to the lesion may take only minutes or less if vascular compromise to or transection of the cord develops. Chronic compression may be caused by bony or cartilaginous protrusions into the cervical, thoracic, or lumbar spinal canal (eg, from osteophytes or spondylosis, especially in patients with a congenitally narrow spinal canalsee
Pictures Of Epidural Abscess Complicating Frontal Sinusitis * Otolaryngology Hou
epidural abscess, A complication of frontal sinusitis. CT scan shows pusin frontal sinus and epidural abscess. Trephination sinus.
http://www.ghorayeb.com/FrontalEpiduralAbscess.html
Pott's Puffy Tumor. Complication Of Frontal Sinusitis. Otolaryngology Houston
Intracranial complications such as epidural abscess, subdural empyema, meningitis,cerebral abscess, and duralvein thrombophlebitis may also occur.
http://www.ghorayeb.com/PottsPuffyTumor.html

Extractions: It consists of a subperiosteal abscess and osteomyelitis of the frontal bone. Patients present with a tender doughy soft tissue swelling that causes pitting edema over the frontal bone. Intracranial complications such as epidural abscess, subdural empyema, meningitis , cerebral abscess, and dural-vein thrombophlebitis may also occur. Treatment consists of surgical drainage of the abscess and the frontal sinus and 6 weeks of intravenous antibiotic therapy directed at the isolated organisms. Trephination is carried out in the floor of the sinus. A drain placed through the trephine allows the drainage of sinus contents and can be used to irrigate with antibiotic solutions.
PYOGENIC SPINAL EPIDURAL ABSCESS
PYOGENIC SPINAL epidural abscess. Over the last 10 years, four cases of spinal epiduralabscess have been admitted and treated at King Fahd University Hospital.
http://www.kfshrc.edu.sa/annals/193/97-307R.html

Extractions: Mohammed Moussa, MD ; Fikry El Morsy, MD Over the last 10 years, four cases of spinal epidural abscess have been admitted and treated at King Fahd University Hospital. Three of these patients were surgically treated, while one was treated conservatively. Acid-fast bacilli (AFB) were not detected in any of the cases. All four patients were put on antibiotics for periods of 4-8 weeks and showed remarkable recovery. Case 1 No AFB were detected by direct smear and culture. Klebsiella spp. was isolated and the patient was treated with piperacillin, meropenem and cefamandole for five weeks. The patient showed immediate improvement postoperatively, and had another operation for thoracotomy and removal of the chest abscess a week after the first surgery. He improved markedly and was discharged, walking normally after four weeks. Case 2 From the Departments of Orthopedic Surgery (Drs. Al-Othman and Moussa), Neurosurgery (Dr. Ammar), and Microbiology (Dr. El Morsy), King Faisal University and King Fahd University Hospital, Al-Khobar, Saudi Arabia. our hospital complaining of severe lumbar pain. He had no neurological deficit, had normal motor power and normal control of the sphincters. He was highly febrile, with a temperature of 39ºC. Lumbar x-rays and CT scan showed a small epidural abscess at the level of L1-L2, extending from the thoracic cavity. No evidence of osteomyelitis was detected. The patient was treated conservatively with antibiotics (gentamycin and ceftriaxone) and painkillers (voltaren) for six weeks. He showed marked improvement and was discharged home after eight weeks.
Health Ency.: Disease: Epidural Abscess
epidural abscess. epidural abscess is a rare disorder. Nine out often cases are located in the spine (spinal epidural abscess).
http://www.accessatlanta.com/shared/health/adam/ency/article/001416.html

Extractions: Important notice Ency. home Disease E Epidural abscess Overview Symptoms Treatment Prevention 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. Causes and Risks 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.
Health Ency.: Disease: Epidural Abscess
epidural abscess. Spinal epidural abscess Fever and back pain (the back pain maybe confined to the spine or may radiate to the extremities, the arms or legs);
http://www.accessatlanta.com/shared/health/adam/ency/article/001416sym.html

Extractions: Important notice Ency. home Disease E Epidural abscess Overview Symptoms Treatment Prevention Alternative names: Abscess - epidural Symptoms Spinal epidural abscess: Intracranial epidural abscess: Signs and Tests Persistent back pain with fever or headache with fever should lead to medical evaluation including a neurological exam to look for focal neurological deficits (loss of neurologic functions such as movement or sensation). Tests such as CT (cat scan) or MRI are frequently needed to confirm the presence of epidural abcess.
CCHS Clinical Digital Library
epidural abscess Clinical Resources. Miscellaneous epidural abscess Clinical ResourcesHealth Reviews for Primary Care Providers on the Internet Homepage
http://cchs-dl.slis.ua.edu/clinical/infectious/bybodysystem/cns/epiduralabscess.

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 Health Sciences 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
Epidural Abscess Spinal
Spinal epidural abscess. If a patient's back pain is not midline and not associatedwith point tenderness it is probably not from a spinal epidural abscess.
http://uscneurosurgery.com/glossary/e/epidural abscess spinal.htm

Extractions: Spinal epidural abscess Collection of pus in the epidural space around the spinal cord. This diagnosis should be strongly considered in any patient with fever and back pain. If a patient's back pain is not midline and not associated with point tenderness it is probably not from a spinal epidural abscess. The reason why spinal cord function fails along an epidural abscess is not known. There ischemia and infarction of the cord which is due to either or a combination of compression and inflammation. Compression results from a mass of pus growing and expanding the narrow space between the spinal cord and the bony wall of the spinal canal. At a volume of ten cubic centimeters (two or three teaspoonsful) a mass of pus begins to indent the spinal cord pushing it over and into the unyielding wall of the intervertebral canal. At a certain critical pressure (ergs per square centimeter) axonal transport and other neuronal functions necessary for normal message transmission and neurologic function, cease.
Spinal Epidural Infections
If a patient's back pain is not midline and not associated with point tendernessit is probably not from a spinal epidural abscess. Spinal epidural abscess.
http://uscneurosurgery.com/glossary/s/spinal_epidural_infections.htm

Extractions: The reason why spinal cord function fails along an epidural abscess is not known. There ischemia and infarction of the cord which is due to either or a combination of compression and inflammation. Compression results from a mass of pus growing and expanding the narrow space between the spinal cord and the bony wall of the spinal canal. At a volume of ten cubic centimeters (two or three teaspoonsful) a mass of pus begins to indent the spinal cord pushing it over and into the unyielding wall of the intervertebral canal. At a certain critical pressure (ergs per square centimeter) axonal transport and other neuronal functions necessary for normal message transmission and neurologic function, cease.
Spinal Epidural Abscess: 1-Year Survey
Incidence of Spinal epidural abscess after Epidural Analgesia A National1year Survey Wang LP et al. Anesthesiology. 91(6)1928-36, 1999 Dec.
http://freespace.virgin.net/info.anesedrp/Wang-EpidAbscess-Fletcher.html

Extractions: Incidence of Spinal Epidural Abscess after Epidural Analgesia: A National 1-year Survey Wang LP et al. Anesthesiology. 91(6):1928-36, 1999 Dec. Reviewed by: James Fletcher, MD Summary: Results: Level: 5 thoracic, 4 lumbar Indications: 6 post-op pain, 2 cancer pain, 1 trauma pain Symptoms: 1 meningitis, 5 febrile, 6 signs of local infection, 6 localized back pain, 7 paraplegic symptoms Staph aureus in 5 pts, coag neg staph in one, no growth in 2
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Spinal epidural abscess After Corticosteroid Injections from Southern MedicalJournal Posted 09/11/2002 Vijay K. Koka, MD, MPH, and Anil Potti, MD.
http://www.medscape.com/viewarticle/439456
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Spinal epidural abscess After Corticosteroid Injections from SouthernMedical Journal. Discussion. Spinal epidural abscess is uncommon
http://www.medscape.com/viewarticle/439456_3
Spinal Epidural Abscess
26, 1996. Spinal epidural abscess. Suggested Reading. Darouiche, RO, Hamill, RJ,Greenberg, SB, Weathers, SW, Musher, DM Bacterial Spinal epidural abscess.
http://www.ccm.lsuhsc-s.edu/bugbytes/Volume3/bb-v3n2.htm

Extractions: Although virtually any organism can cause SEA, Staphylococcus aureus causes 60-90% of all cases. Less common pathogens include M. tuberculosis, fungi, and even parasites. The combination of back pain, fever, and local vertebral tenderness upon palpation or percussion of the spine strongly suggests a SEA. This triad constitutes adequate reason to obtain a Magnetic Resonance Imaging (MRI) scan and to request neurosurgical help in evaluating the patient. Approximately 66% of patients with SEA present within two weeks of the development of symptoms. Historically, SEA has been characterized by four clinical stages: Stage 1 - Spinal ache; Stage 2 - Root Pain; Stage 3 - Weakness; and Stage 4 - Paralysis. As damage to the spinal cord progresses, the patient may exhibit bowel and bladder dysfunction, weakness or paralysis of the extremities, and sensory deficits. However, neurologic deterioration is highly variable and may not progress from one stage to the next in an orderly manner. Because it is not uncommon for acute SEA to progress from Stages 1 or 2 to Stage 4 (paralysis) in a matter of hours, the utility of staging SEA is questionable. Traditionally, SEA has been considered a neurosurgical emergency. Standard management of patients with non-tuberculous SEA (NT-SEA) is immediate surgical drainage and decompression followed by six or more weeks of antimicrobial therapy directed against the organism isolated at surgery. Because
Iatrogenic Spinal Epidural Abscess And Discitis After Lumbar Disc Surgery: Can E
Iatrogenic spinal epidural abscess and discitis after lumbar disc surgeryCan epidural steroids be responsible for abscess formation?
http://med.ege.edu.tr/norolbil/2001/2001_3_32.htm

Extractions: Journal of Neurological Sciences (Turkish) Online Resources Table of Contents Norol Bil D, Volume 18, Issue 3: July-September 2001, #32 S. Naderi, F. Acar and, MN. Arda Dokuz Eylül University School of Medicine, Department Neurosurgery, Inciralti, Izmir , Turkey ABSTRACT A 67-year-old male was operated for a recurrent L4-5 disc herniation. Intraoperative corticosteroid was used topically on epidural space before closure. 15 days after surgery he was readmitted because of severe pain in low back and lower extremities. A lumbar epidural abscess was diagnosed and he was reoperated, his abscess was drained and he was treated with parenteral antibiotics. In this article effect of intraoperative topical epidural corticosteroid usage on postoperative epidural abscess is discussed and literature is reviewed. It is stated that, postoperative lumbar epidural abscess is a benign disease in case treated properly. Surgical drainage and 3-4 weeks of parenteral antibiotherapy is adequate. Key words: iatrogenic epidural abscess, lumbar disc surgery, steroid.
UCLA NEUROSURGERY | Spinal Disorders & Diseases
SPINAL DISEASES DISORDERS Spinal epidural abscess. What is a spinalepidural abscess? A How common is spinal epidural abscess? The
http://www.neurosurgery.medsch.ucla.edu/Diagnoses/Spinal/SpinalDis_14.html

Extractions: COMPREHENSIVE SPINE PROGRAM COMPREHENSIVE SPINE DIAGNOSES INDEX What is a spinal epidural abscess? A spinal epidural abscess is an infection localized to the epidural space in the spinal column. The epidural space is between the bony spine and the dura mater. This infection can result in compression of the spinal cord and nerves as they leave the spinal canal. How common is spinal epidural abscess? The incidence of spinal epidural abscess is approximately 0.2 - 1.2 per 10,000 hospital admissions annually. The average age of patients with this condition is 57 years. 65% of patients with spinal epidural abscess have chronic disease associated with compromised immunity. Other associated conditions include diabetes mellitus (32%), IV drug abuse (18%), chronic renal failure (12%), and alcoholism (10%). Where are spinal epidural abscesses located? The thoracic level is the most common site reported (50%), followed by lumbar (35%) then cervical (15%). 82% of the infections are posterior (located toward the back), while 18% are anterior (located toward the front). What are the clinical features of a spinal epidural abscess?
Medi-Fax Atlas Series - Epidural Abscess
epidural abscess. Contributor Dr. Chris Ekong. Case 1. MRI of Cervical spine showingC34 epidural abscess. A Project of The Emmanuel Charitable Foundation.
http://www.medi-fax.com/atlas/spineinfection/case1.html

Extractions: Editor: Dr. Chris Ekong Navigation Atlas Series Health Information CDs Health Information Centre ThinkFirst Web Pages ... Links Epidural Abscess Contributor: Dr. Chris Ekong Case 1 Age: Sex: Female History: Sudden severe neck pain in an immunosupressed lady with renal failure who has been receiving dialysis for last 3 years. Examination showed slight tenderness in the cervical region. Pre-op X-Rays MRI of Cervical spine showing C34 epidural abscess. A Project of The Emmanuel Charitable Foundation Last Updated: September 18, 2001
NEJM -- Spinal Epidural Abscess
Original Article from The New England Journal of Medicine Spinal epidural abscess. Spinalepidural abscess AS Baker, RG Ojemann, MN Swartz, and EP Richardson.
http://content.nejm.org/cgi/content/short/293/10/463

Extractions: This article has been cited by other articles: Phillips, J. M. G., Stedeford, J. C., Hartsilver, E., Roberts, C. (2002). Epidural abscess complicating insertion of epidural catheters. Br J Anaesth [Abstract] [Full Text] (2002). Back pain and systemic compromise. Postgrad Med J [Full Text] Aram, L., Krane, E. J., Kozloski, L. J., Yaster, M. (2001). Tunneled Epidural Catheters for Prolonged Analgesia in Pediatric Patients. Anesth Analg [Abstract] [Full Text] Batchelor, T. T., Louis, D. N. (1997). Case 39-1997- A 67-Year-Old Woman with the Cauda Equina Syndrome. N Engl J Med [Full Text] Harrington, P, Millner, P A, Veale, D (2001). Inappropriate medical management of spinal epidural abscess. Ann Rheum Dis [Abstract] [Full Text] Mackenzie, A R, Laing, R B S, Smith, C C, Kaar, G F, Smith, F W (1998). Spinal epidural abscess: the importance of early diagnosis and treatment.
NEJM -- Spinal Epidural Abscess
Next Next. Spinal epidural abscess AS Baker, RG Ojemann, MN Swartz, and EP Richardson. In16 per cent epidural abscess was due to postoperative infection.
http://content.nejm.org/cgi/content/abstract/293/10/463

Extractions: This article has been cited by other articles: Phillips, J. M. G., Stedeford, J. C., Hartsilver, E., Roberts, C. (2002). Epidural abscess complicating insertion of epidural catheters. Br J Anaesth [Abstract] [Full Text] (2002). Back pain and systemic compromise. Postgrad Med J [Full Text] Aram, L., Krane, E. J., Kozloski, L. J., Yaster, M. (2001). Tunneled Epidural Catheters for Prolonged Analgesia in Pediatric Patients. Anesth Analg [Abstract] [Full Text] Batchelor, T. T., Louis, D. N. (1997). Case 39-1997- A 67-Year-Old Woman with the Cauda Equina Syndrome. N Engl J Med [Full Text] Harrington, P, Millner, P A, Veale, D (2001). Inappropriate medical management of spinal epidural abscess. Ann Rheum Dis [Abstract] [Full Text] Mackenzie, A R, Laing, R B S, Smith, C C, Kaar, G F, Smith, F W (1998). Spinal epidural abscess: the importance of early diagnosis and treatment.
Epidural Abscess And Staphylococcus Aureus Endocarditis - A Rare Association - P
epidural abscess and Staphylococcus Aureus Endocarditis A Rare Association P.Malhotra, S. Jain, S. Kumari, Paramjeet , S. Varma Departments of Internal
http://www.neurologyindia.com/vol50-3/1625ab.php

Extractions: Summary : Epidural abscess is a relatively uncommon disorder. Although the surgical management is the mainstay of treatment, there are case reports of it being managed conservatively in selected patients. We report a patient who presented with quadreparesis due to epidural abscess and had infective endocarditis due to Staphylococcus aureus septicemia. Both epidural abscess and infective endocarditis were managed conservatively with intravenous antibiotics given for four weeks, with complete recovery of patient. Full Article Full Articles are available in .pdf format. To view these, you require
Primary Cutaneous Nocardiosis With Epidural Abscess Caused By Nocardia Brasilien
Primary Cutaneous Nocardiosis with epidural abscess Caused by Nocardia brasiliensis A Case Report V. Lakshmi, C. Sundaram, AK Meena, J. MK Murthy Departments
http://www.neurologyindia.com/vol50-1/1558ab.php

Extractions: Summary : Dissemination of primary cutaneous nocardiosis is a rare event. An interesting case of a 20 year old female labourer with progressive weakness in both the lower limbs and large multiple subcutaneous abscesses over the back, since 4 years, is presented. MRI showed an epidural abscess compressing the cord. Histopathology of skin lesions suggested a chronic suppurative lesion. Microbiological tests on the aspirate from the skin lesion identified the causative organism as Nocardia brasiliensis. Full Article Full Articles are available in .pdf format. To view these, you require Acrobat Reader

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