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Holospinal epidural abscess in elderly patient: A case presentation and review

BACKGROUND: Holospinal epidural abscess (HEA) is a rare pathological entity with significant morbidity and mortality rates. Here, we present a 74-year-old male with HEA treated with focal skip laminectomies and catheter irrigation. CASE DESCRIPTION: A 74-year-old male presented with fever, neck/back...

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Autores principales: Siasios, Ioannis D., Fotiadou, Aggeliki, Fountas, Kostas, Dimopoulos, Vassilios
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Scientific Scholar 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6826316/
https://www.ncbi.nlm.nih.gov/pubmed/31768284
http://dx.doi.org/10.25259/SNI_436_2019
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author Siasios, Ioannis D.
Fotiadou, Aggeliki
Fountas, Kostas
Dimopoulos, Vassilios
author_facet Siasios, Ioannis D.
Fotiadou, Aggeliki
Fountas, Kostas
Dimopoulos, Vassilios
author_sort Siasios, Ioannis D.
collection PubMed
description BACKGROUND: Holospinal epidural abscess (HEA) is a rare pathological entity with significant morbidity and mortality rates. Here, we present a 74-year-old male with HEA treated with focal skip laminectomies and catheter irrigation. CASE DESCRIPTION: A 74-year-old male presented with fever, neck/back pain, and slight weakness in his legs bilaterally (4/5). The patient underwent a magnetic resonance imaging (MRI) of the entire spine showing an epidural collection extending from C5-C6 to the L4-L5 levels. Laboratory studies revealed a leukocytosis and an elevated C-reaction protein level. Blood cultures were positive for methicillin-sensitive Staphylococcus aureus. The patient underwent skip laminectomies at C6 and C7; T2, T3, T5, T6, T8, T9, T10, and T12; and L3, L4, and L5 with catheter irrigation between these levels; this minimized the risk of postoperative kyphosis and instability. His postoperative course was uneventful. Other surgical approaches to HEA described in literature include laminectomy, focal laminectomies, and skip laminectomies. CONCLUSION: In this case of a holospinal HEA, skip laminectomies and catheter irrigation avoided neurological deterioration and delayed spinal instability in a 74-year-old male.
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spelling pubmed-68263162019-11-25 Holospinal epidural abscess in elderly patient: A case presentation and review Siasios, Ioannis D. Fotiadou, Aggeliki Fountas, Kostas Dimopoulos, Vassilios Surg Neurol Int Case Report BACKGROUND: Holospinal epidural abscess (HEA) is a rare pathological entity with significant morbidity and mortality rates. Here, we present a 74-year-old male with HEA treated with focal skip laminectomies and catheter irrigation. CASE DESCRIPTION: A 74-year-old male presented with fever, neck/back pain, and slight weakness in his legs bilaterally (4/5). The patient underwent a magnetic resonance imaging (MRI) of the entire spine showing an epidural collection extending from C5-C6 to the L4-L5 levels. Laboratory studies revealed a leukocytosis and an elevated C-reaction protein level. Blood cultures were positive for methicillin-sensitive Staphylococcus aureus. The patient underwent skip laminectomies at C6 and C7; T2, T3, T5, T6, T8, T9, T10, and T12; and L3, L4, and L5 with catheter irrigation between these levels; this minimized the risk of postoperative kyphosis and instability. His postoperative course was uneventful. Other surgical approaches to HEA described in literature include laminectomy, focal laminectomies, and skip laminectomies. CONCLUSION: In this case of a holospinal HEA, skip laminectomies and catheter irrigation avoided neurological deterioration and delayed spinal instability in a 74-year-old male. Scientific Scholar 2019-10-18 /pmc/articles/PMC6826316/ /pubmed/31768284 http://dx.doi.org/10.25259/SNI_436_2019 Text en Copyright: © 2019 Surgical Neurology International http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Case Report
Siasios, Ioannis D.
Fotiadou, Aggeliki
Fountas, Kostas
Dimopoulos, Vassilios
Holospinal epidural abscess in elderly patient: A case presentation and review
title Holospinal epidural abscess in elderly patient: A case presentation and review
title_full Holospinal epidural abscess in elderly patient: A case presentation and review
title_fullStr Holospinal epidural abscess in elderly patient: A case presentation and review
title_full_unstemmed Holospinal epidural abscess in elderly patient: A case presentation and review
title_short Holospinal epidural abscess in elderly patient: A case presentation and review
title_sort holospinal epidural abscess in elderly patient: a case presentation and review
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6826316/
https://www.ncbi.nlm.nih.gov/pubmed/31768284
http://dx.doi.org/10.25259/SNI_436_2019
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