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Fatal Cervical Spinal Epidural Abscess and Spondylodiscitis Complicated With Rhombencephalitis Caused by Klebsiella pneumoniae: A Case Report and Literature Review

Spinal epidural abscess (SEA) is a rare but sometimes life-threatening condition. The principal organisms in SEA and spondylodiscitis are gram-positive bacteria, e.g., Staphylococcus aureus and Streptococci. Spontaneous gram-negative SEA and spondylodiscitis especially Klebsiella pneumoniae are very...

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Autores principales: Nitinai, Nattapat, Punpichet, Minth, Nasomsong, Worapong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8723735/
https://www.ncbi.nlm.nih.gov/pubmed/35003954
http://dx.doi.org/10.7759/cureus.20100
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author Nitinai, Nattapat
Punpichet, Minth
Nasomsong, Worapong
author_facet Nitinai, Nattapat
Punpichet, Minth
Nasomsong, Worapong
author_sort Nitinai, Nattapat
collection PubMed
description Spinal epidural abscess (SEA) is a rare but sometimes life-threatening condition. The principal organisms in SEA and spondylodiscitis are gram-positive bacteria, e.g., Staphylococcus aureus and Streptococci. Spontaneous gram-negative SEA and spondylodiscitis especially Klebsiella pneumoniae are very rare. We report a 71-year-old Thai male with diabetes, presenting fever, enlarged neck mass, and progressive painful swallowing a week before admission. MRI of the whole spine demonstrated epidural abscess along the anterior thecal sac from C2 to C7 levels with spinal meningitis; multiple rim-enhancing lesions at the left sternocleidomastoid/levator scapulae, splenius capitis, semispinalis capitis, and bilateral scalene muscles; and rhombencephalitis with brain abscess. Klebsiella pneumoniae was isolated from blood culture. CT of the whole abdomen showed unremarkable intra-abdominal lesion. Intravenous ceftriaxone was administered, but the patient was unable to undergo surgical drainage due to unstable condition and died after two weeks of admission. Spontaneous SEA and spondylodiscitis caused by K. pneumoniae are very rare but sometimes fatal. In the case of SEA and spondylodiscitis, even when K. pneumoniae is uncommon, it should be also considered as a pathogen, especially when the patient had important risk factors.
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spelling pubmed-87237352022-01-06 Fatal Cervical Spinal Epidural Abscess and Spondylodiscitis Complicated With Rhombencephalitis Caused by Klebsiella pneumoniae: A Case Report and Literature Review Nitinai, Nattapat Punpichet, Minth Nasomsong, Worapong Cureus Internal Medicine Spinal epidural abscess (SEA) is a rare but sometimes life-threatening condition. The principal organisms in SEA and spondylodiscitis are gram-positive bacteria, e.g., Staphylococcus aureus and Streptococci. Spontaneous gram-negative SEA and spondylodiscitis especially Klebsiella pneumoniae are very rare. We report a 71-year-old Thai male with diabetes, presenting fever, enlarged neck mass, and progressive painful swallowing a week before admission. MRI of the whole spine demonstrated epidural abscess along the anterior thecal sac from C2 to C7 levels with spinal meningitis; multiple rim-enhancing lesions at the left sternocleidomastoid/levator scapulae, splenius capitis, semispinalis capitis, and bilateral scalene muscles; and rhombencephalitis with brain abscess. Klebsiella pneumoniae was isolated from blood culture. CT of the whole abdomen showed unremarkable intra-abdominal lesion. Intravenous ceftriaxone was administered, but the patient was unable to undergo surgical drainage due to unstable condition and died after two weeks of admission. Spontaneous SEA and spondylodiscitis caused by K. pneumoniae are very rare but sometimes fatal. In the case of SEA and spondylodiscitis, even when K. pneumoniae is uncommon, it should be also considered as a pathogen, especially when the patient had important risk factors. Cureus 2021-12-02 /pmc/articles/PMC8723735/ /pubmed/35003954 http://dx.doi.org/10.7759/cureus.20100 Text en Copyright © 2021, Nitinai et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Internal Medicine
Nitinai, Nattapat
Punpichet, Minth
Nasomsong, Worapong
Fatal Cervical Spinal Epidural Abscess and Spondylodiscitis Complicated With Rhombencephalitis Caused by Klebsiella pneumoniae: A Case Report and Literature Review
title Fatal Cervical Spinal Epidural Abscess and Spondylodiscitis Complicated With Rhombencephalitis Caused by Klebsiella pneumoniae: A Case Report and Literature Review
title_full Fatal Cervical Spinal Epidural Abscess and Spondylodiscitis Complicated With Rhombencephalitis Caused by Klebsiella pneumoniae: A Case Report and Literature Review
title_fullStr Fatal Cervical Spinal Epidural Abscess and Spondylodiscitis Complicated With Rhombencephalitis Caused by Klebsiella pneumoniae: A Case Report and Literature Review
title_full_unstemmed Fatal Cervical Spinal Epidural Abscess and Spondylodiscitis Complicated With Rhombencephalitis Caused by Klebsiella pneumoniae: A Case Report and Literature Review
title_short Fatal Cervical Spinal Epidural Abscess and Spondylodiscitis Complicated With Rhombencephalitis Caused by Klebsiella pneumoniae: A Case Report and Literature Review
title_sort fatal cervical spinal epidural abscess and spondylodiscitis complicated with rhombencephalitis caused by klebsiella pneumoniae: a case report and literature review
topic Internal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8723735/
https://www.ncbi.nlm.nih.gov/pubmed/35003954
http://dx.doi.org/10.7759/cureus.20100
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