Pneumorachis from the cervical to the sacral spinal canal with spinal epidural abscess by gas gangrene

Abstract

We present a 70-year-old woman with severe diabetes mellitus, who experienced low back pain and left lower leg paralysis. Computed tomography showed air in the spinal canal from C4 to S5, and magnetic resonance imaging revealed an epidural abscess from Th11 to L1. Laboratory findings showed increases in inflammatory indicators and blood culture indicated the presence of Escherichia coli. The patient was treated conservatively with antibiotics. Neurological deficits and inflammatory data improved during the course. Follow-up imaging studies showed the disappearance of gas and epidural abscess. The existence of air in the spinal canal is a rare condition known as pneumorachis. To the best of our knowledge, such a long pneumorachis ranging from the cervical to the sacral spinal canal with epidural abscess caused by gas gangrene has not yet been described. We should therefore realize the possibility of epidural abscess produced by gas gangrene and treat it appropriately.

Pneumorrhachis Secondary to an Infected Sacral Decubitus Ulcer

“…There are some cases of PR associated with infectious diseases, such as epidural abscesses, hematogenous dissemination, intraperitoneal sepsis and complications of decubitus ulcer [2,3,7,8]. The involvement and production of gas by gangrene in the spinal canal is extremely rare [9]. PR is normally asymptomatic and therefore the diagnosis is mainly imagiological [1,6,7].…”