Upper Cervical Epidural Abscess Resulting in Respiratory Compromise After Lumbar Steroid Injection.
J Emerg Med
; 57(1): 66-69, 2019 Jul.
Article
em En
| MEDLINE
| ID: mdl-31003824
ABSTRACT
BACKGROUND:
Spinal epidural abscesses have a prevalence of 3 out of every 10,000 admissions. Abscesses above the level of C2, defined as upper cervical epidural abscesses, are even rarer still. CASE REPORT We discuss a case in which a 45-year-old male patient developed an upper cervical epidural abscess 48 h after receiving a lumbar steroid injection. The patient presented with diminished strength in all four extremities and respiratory distress secondary to the space-occupying lesion near his spinal cord. His hospital course included surgical decompression and antibiotics. He was eventually discharged to rehabilitation, but never regained full strength in his arms or legs. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS? Patients who present with back or neck pain, fever, and neurologic deficits may have epidural abscess. In some patients, neurologic deficits may include respiratory distress if the upper cervical region is involved, and these patients have the possibility of airway decompensation. The diagnostic imaging modality of choice in patients with epidural abscess is MRI with gadolinium. Management involves supportive care, broad-spectrum antibiotics, which include coverage for methicillin-resistant Staphylococcus aureus, and early neurosurgical consultation.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Esteroides
/
Abscesso Epidural
Tipo de estudo:
Risk_factors_studies
Limite:
Humans
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Male
/
Middle aged
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article