Intramedullary spinal cord abscess suspected of <i>Brucella</i> infection

Helvacı, Mehmet Rami; Kasırga, Erhun; Cetın, Nuran; Yaprak, Işın

doi:10.1046/j.1442-200x.2002.01569.x

Cited by 18 publications

(12 citation statements)

References 12 publications

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“…Twenty-five patients with ISCA were identified in addition to the present patient, 18 males and 8 females aged 1 month to 74 years (mean 32 years). 1,5,[8][9][10][11][12]14,16,20,[23][24][25][26][27][29][30][31][32][33][34][35][36] No significant difference was found in mean age between women and men (22 years vs. 36 years; p ＝ 0.16), but women tended to be affected in the first five decades, whereas men were affected mainly in the first and sixth decades (Fig. 3).…”

Section: Resultsmentioning

confidence: 99%

“…Previously, emergent surgery has been performed immediately after the diagnosis of ISCA, except in three cases in which 1 week of conservative therapy preceded the operation. 1,16,24) In any case, if antibiotic therapy does not improve the symptoms, surgery (laminectomy, myelotomy, and abscess drainage) should be performed promptly. Therefore, we need to determine the duration of antibiotic administration that gives optimum treatment efficacy.…”

Section: Discussionmentioning

confidence: 99%

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Intramedullary Spinal Cord Abscess Treated With Antibiotic Therapy -Case Report and Review-

Kurita

Sakurai

Taniguchi

et al. 2009

Neurol. Med. Chir.(Tokyo)

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A 58-year-old man presented with an intramedullary spinal cord abscess (ISCA) manifesting as posterior neck pain, gait disturbance, and urinary retention, and transverse myelopathy 1 week later. Magnetic resonance imaging showed the ISCA at the C7 to T1 levels. He was treated under a diagnosis of cryptogenic ISCA with high-dose ampicillin and third- or fourth-generation cephalosporins, which resulted in complete recovery after 2 months. Review of the literature between January 1998 and August 2007 identified 26 cases of ISCA, including our patient. We also identified two additional nonsurgically treated ISCA patients reported between 1977 and 2007. The most common presentation was motor deficits in all patients, followed by fever, pain, and bladder dysfunction. The mortality rate was 1 of 26 patients, and neurological sequelae were observed in 15 of the 25 surviving patients. There was no significant difference in the frequency of neurological sequelae between surgically and nonsurgically treated patients. Mean length of the abscess in the surgically treated group was significantly larger than that in the medically treated group (5.8 vs. 2.2 vertebral bodies). All three nonsurgically treated patients with neurological sequelae had anaerobic infections and received antibiotic therapy later and for shorter periods than those with complete neurological recovery. Antibiotic treatment is comparable to surgery plus antibiotic treatment. Early broad-spectrum high-dose ampicillin and third-generation cephalosporin, covering Gram-positive, Gram-negative, and anaerobic organisms, should be the first choice of management for patients with ISCA.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Intramedullary Spinal Cord Abscess Treated With Antibiotic Therapy -Case Report and Review-

Kurita

Sakurai

Taniguchi

et al. 2009

Neurol. Med. Chir.(Tokyo)

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“…Cultures of the purulent material were negative. She was treated with a total of 8 weeks of antibiotics with which she recovered considerably [5]. …”

Section: Discussionmentioning

confidence: 99%

“…Extensive intra-medullary spinal cord abscess due to Brucella , is exceedingly rare. Only four other cases have been reported so far [2-5]. We present a case of intra-medullary spinal cord abscess in which Brucella melitensis was cultured from pus.…”

Section: Introductionmentioning

confidence: 94%

Neurobrucellosis presenting as an intra-medullary spinal cord abscess

Vajramani

Nagmoti

Patil

2005

Ann Clin Microbiol Antimicrob

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“…Tras un periodo de incubación de 2 a 8 semanas se instaura una forma aguda en la que los síntomas que aparecen son inespecíficos y suelen englobar la aparición de cefalea, sudoración y fiebre ondulante, con alguna afectación focal específica. De todas ellas la más común es la focalidad osteoarticular (100), fundamentalmente en forma de espondilitis y sacroileitis, si bien el espectro es amplio, tal y como se refleja en la tabla VII, pudiendo consistir en afectación gastrointestinal, hepática, neurotropa (101,102), respiratoria (103), génitourinaria (104), y cardiovascular (105), entre otras (106). En la actualidad, a pesar de la controversia conceptual existente, se suele aceptar que las formas crónicas de brucelosis son aquellas en las que la sintomatología persiste más de 12 meses.…”

Section: Brucelosisunclassified