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Insidious Onset of Tetraparesis due to Cervical Epidural Abscess from Enterococcus faecalis

We report a case of cervical epidural abscess from Enterococcus faecalis, which caused an insidious onset of tetraparesis. This 53-year-old female with a history of diabetes mellitus and chronic renal failure under hemodialysis presented with pain and progressive weakness of upper and lower extremit...

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Autores principales: Soultanis, Konstantinos Chr., Sakellariou, Vasileios I., Starantzis, Konstantinos A., Stavropoulos, Nikolaos A., Papagelopoulos, Panayiotis J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3616352/
https://www.ncbi.nlm.nih.gov/pubmed/23573096
http://dx.doi.org/10.1155/2013/513920
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author Soultanis, Konstantinos Chr.
Sakellariou, Vasileios I.
Starantzis, Konstantinos A.
Stavropoulos, Nikolaos A.
Papagelopoulos, Panayiotis J.
author_facet Soultanis, Konstantinos Chr.
Sakellariou, Vasileios I.
Starantzis, Konstantinos A.
Stavropoulos, Nikolaos A.
Papagelopoulos, Panayiotis J.
author_sort Soultanis, Konstantinos Chr.
collection PubMed
description We report a case of cervical epidural abscess from Enterococcus faecalis, which caused an insidious onset of tetraparesis. This 53-year-old female with a history of diabetes mellitus and chronic renal failure under hemodialysis presented with pain and progressive weakness of upper and lower extremities without fever. Although a recent MRI she did at the beginning of symptoms showed no significant pathologies, except for a cervical disc herniation and adjacent spinal degeneration, and stenosis that confused the diagnostic procedure, newer imaging with CT and MRI, which was performed due to progression of tetraparesis, revealed the formation of a cervical epidural abscess. Surgical drainage was done after a complete infection workup. The patient showed immediate neurological improvement after surgery. She received antibiotics intravenously for 3 weeks and orally for another 6 weeks. The patient was free from complications 24 months after surgery. A high index of suspicion is most important in making a rapid and correct diagnosis of spinal epidural abscess. The classic clinical triad (fever, local pain, and neurologic deficits) is not sensitive enough for early detection. Continuous clinical, laboratory, and imaging monitoring are of paramount importance. Early diagnosis and surgical intervention could optimize the final functional outcome.
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spelling pubmed-36163522013-04-09 Insidious Onset of Tetraparesis due to Cervical Epidural Abscess from Enterococcus faecalis Soultanis, Konstantinos Chr. Sakellariou, Vasileios I. Starantzis, Konstantinos A. Stavropoulos, Nikolaos A. Papagelopoulos, Panayiotis J. Case Rep Med Case Report We report a case of cervical epidural abscess from Enterococcus faecalis, which caused an insidious onset of tetraparesis. This 53-year-old female with a history of diabetes mellitus and chronic renal failure under hemodialysis presented with pain and progressive weakness of upper and lower extremities without fever. Although a recent MRI she did at the beginning of symptoms showed no significant pathologies, except for a cervical disc herniation and adjacent spinal degeneration, and stenosis that confused the diagnostic procedure, newer imaging with CT and MRI, which was performed due to progression of tetraparesis, revealed the formation of a cervical epidural abscess. Surgical drainage was done after a complete infection workup. The patient showed immediate neurological improvement after surgery. She received antibiotics intravenously for 3 weeks and orally for another 6 weeks. The patient was free from complications 24 months after surgery. A high index of suspicion is most important in making a rapid and correct diagnosis of spinal epidural abscess. The classic clinical triad (fever, local pain, and neurologic deficits) is not sensitive enough for early detection. Continuous clinical, laboratory, and imaging monitoring are of paramount importance. Early diagnosis and surgical intervention could optimize the final functional outcome. Hindawi Publishing Corporation 2013 2013-03-20 /pmc/articles/PMC3616352/ /pubmed/23573096 http://dx.doi.org/10.1155/2013/513920 Text en Copyright © 2013 Konstantinos Chr. Soultanis et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Soultanis, Konstantinos Chr.
Sakellariou, Vasileios I.
Starantzis, Konstantinos A.
Stavropoulos, Nikolaos A.
Papagelopoulos, Panayiotis J.
Insidious Onset of Tetraparesis due to Cervical Epidural Abscess from Enterococcus faecalis
title Insidious Onset of Tetraparesis due to Cervical Epidural Abscess from Enterococcus faecalis
title_full Insidious Onset of Tetraparesis due to Cervical Epidural Abscess from Enterococcus faecalis
title_fullStr Insidious Onset of Tetraparesis due to Cervical Epidural Abscess from Enterococcus faecalis
title_full_unstemmed Insidious Onset of Tetraparesis due to Cervical Epidural Abscess from Enterococcus faecalis
title_short Insidious Onset of Tetraparesis due to Cervical Epidural Abscess from Enterococcus faecalis
title_sort insidious onset of tetraparesis due to cervical epidural abscess from enterococcus faecalis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3616352/
https://www.ncbi.nlm.nih.gov/pubmed/23573096
http://dx.doi.org/10.1155/2013/513920
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