Cervical spinal epidural abscess and meningitis due to Prevotella oris and Peptostreptococcus micros after retropharyngeal surgery

Frat, Jean‐Pierre; Godet, C.; Grollier, G.; Blanc, Jean-Luc; Robert, R.

doi:10.1007/s00134-004-2265-x

Cited by 35 publications

(23 citation statements)

References 4 publications

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“…Although anaerobes are often considered contaminants because they are normal flora on human skin and mucosal surfaces, numerous case reports detail the existence and relevance of anaerobic organisms in bacterial meningitis (12)(13)(14)(15)(16)(17)(18)(19)(20)(21). These reports highlight some of the predisposing factors for anaerobic menin- gitis, such as infection (otitis media or upper respiratory infections), trauma, a recent surgical procedure, or the presence of CNS hardware, in particular a ventriculoperitoneal shunt (14).…”

Section: Discussionmentioning

confidence: 99%

Routine Testing for Anaerobic Bacteria in Cerebrospinal Fluid Cultures Improves Recovery of Clinically Significant Pathogens

et al. 2014

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cIn North America, the widespread use of vaccines targeting Haemophilus influenzae type b and Streptococcus pneumoniae have dramatically altered the epidemiology of bacterial meningitis, while the methodology for culturing cerebrospinal fluid (CSF) specimens has remained largely unchanged. The aims of this study were 2-fold: to document the current epidemiology of bacterial meningitis at a tertiary care medical center and to assess the clinical utility of routinely querying for anaerobes in CSF cultures. To that end, we assessed CSF cultures submitted over a 2-year period. A brucella blood agar (BBA) plate, incubated anaerobically for 5 days, was included in the culture procedure for all CSF specimens during the second year of evaluation. In the preand postimplementation years, 2,353 and 2,302 CSF specimens were cultured, with 49 and 99 patients having positive culture results, respectively. The clinical and laboratory data for patients with positive cultures were reviewed. Anaerobic bacteria were isolated in the CSF samples from 33 patients post-BBA compared to two patients pre-BBA (P ‫؍‬ 0.01). The anaerobic isolates included Bacteroides thetaiotaomicron (n ‫؍‬ 1), Propionibacterium species (n ‫؍‬ 15), and Propionibacterium acnes (n ‫؍‬ 19) isolates; all of these isolates were recovered on the BBA. Eight of the 35 patients from whom anaerobic organisms were isolated received antimicrobial therapy. Although six of these patients had central nervous system hardware, two patients did not have a history of a neurosurgical procedure and had community-acquired anaerobic bacterial meningitis. This study demonstrates that the simple addition of an anaerobically incubated BBA to the culture of CSF specimens enhances the recovery of clinically significant anaerobic pathogens.

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Section: Discussionmentioning

confidence: 99%

Routine Testing for Anaerobic Bacteria in Cerebrospinal Fluid Cultures Improves Recovery of Clinically Significant Pathogens

et al. 2014

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“…Mixed flora with combinations of the above organisms also occurs, as well as infection with oral flora such as Prevotella oris and Peptostreptococcus micros. 1,3,7,16,17 Radiographic evaluation with MRI is the diagnostic test of choice for spinal epidural abscess. MRI with and without gadolinium contrast should be obtained in a timely fashion if the diagnosis of epidural infection is suspected.…”

Section: Joshua E Heller Eli M Baron and Michael W Weavermentioning

confidence: 99%

15 Cerivcal Epidural Abscess

Albert¹,

Lee²,

Lim³

2008

Cervical Spine Surgery Challenges

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“…The incidence of spinal epidural abscesses (SEA) in general ranges between 0.2 and 2/10,000 hospital admissions but those located to the cervical spine only account for not more than 1% of all cases [1–3]. Although rare, they are a medical emergency because they are associated with significant morbidity and mortality if a delay in diagnosis and treatment occurs.…”

Section: Introductionmentioning

confidence: 99%

Insidious Onset of Tetraparesis due to Cervical Epidural Abscess fromEnterococcus faecalis

Soultanis

Sakellariou

Starantzis

et al. 2013

Case Reports in Medicine

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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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Cervical spinal epidural abscess and meningitis due to Prevotella oris and Peptostreptococcus micros after retropharyngeal surgery

Cited by 35 publications

References 4 publications

Routine Testing for Anaerobic Bacteria in Cerebrospinal Fluid Cultures Improves Recovery of Clinically Significant Pathogens

Routine Testing for Anaerobic Bacteria in Cerebrospinal Fluid Cultures Improves Recovery of Clinically Significant Pathogens

15 Cerivcal Epidural Abscess

Insidious Onset of Tetraparesis due to Cervical Epidural Abscess fromEnterococcus faecalis

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