Spinal cord abscess in a heroin addict: case report

Sverzut, J. M.; Laval, C.; Smadja, P.; Gigaud, M.; Sévely, A; Manelfe, C.

doi:10.1007/s002340050623

Cited by 20 publications

(14 citation statements)

References 14 publications

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“…HIV infection, prolonged steroid therapy and drug addiction also seem to play a signi®cant role. 14,19,23 Our patient was neither in an immunocompromised state nor was there any evidence of primary infective focus.…”

Section: Managementmentioning

confidence: 73%

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Holocord intramedullary abscess: an unusual case with review of literature

1999

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Study design: A rare case of a holocord intramedullary abscess with review of literature. Objectives: Summary of clinical presentation, radiology, microbiology, etiology and management of intramedullary spinal cord abscess. Abscess involving the entire spinal cord is extremely rare and awareness of such an event could avoid delay in evacuation of the absess. Methods: The incidence, clinical presentation, radiological investigations, treatment and etiology of intramedullary spinal cord abscess in 100 consecutive cases are discussed. Results: Intramedullary spinal cord abscesses are rare. Presently, only ®ve cases of holocord intramedullary abscess are described. In our analysis of 100 cases of intramedullary abscess, a male preponderance was found. The ®rst and the third decades were the most common age groups. Prognosis is poor if treatment is delayed. Contrast-enhanced MRI is the ideal investigation for diagnosis. Prompt surgical drainage of the abscess with appropriate antibiotic therapy is mandatory since the natural course of the disease has a very unfavourable outcome. Staphylococcus and Streptococcus were the most common causative organisms. Conclusion: Intramedullary spinal cord abscess along the entire length of spinal cord is rare. A thorough history with precise clinical localisation, a high index of suspicion, contrastenhanced MRI at appropriate level and prompt surgical drainage with appropriate antibiotic therapy are key to the eventual outcome and prognosis.

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Section: Managementmentioning

confidence: 73%

“…The veins in the vicinity are frequently thrombosed. 14 The infective foci commonly seen are pneumonitis, genitourinary tract infection, peripheral skin infections, endocarditis and meningitis. 15,23 Abscesses are also associated with dermoids, 29 epidermoids, 22 infected dermal sinus tract, 30 ± 32 ependymomas 33 and spinal dysraphism.…”

Section: Managementmentioning

confidence: 99%

Holocord intramedullary abscess: an unusual case with review of literature

1999

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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%

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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“…Abuse of intravenous drugs has been associated with a higher prevalence of spinal abscess due, in part, to hematogenous spread of bacteria from contaminated syringes and needles . Several studies have documented primary pyogenic infection of the spine in intravenous drug users , and several case studies have reported spinal abscess in patients who are heroin addicts .…”

Section: Introductionmentioning

confidence: 99%

Increased Incidence of Spinal Abscess and Substance Abuse after Implementation of State Mandated Prescription Drug Legislation

Nagar¹,

Springer²,

Salles³

2015

Pain Med

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The results of this retrospective study demonstrate an increased incidence of intraspinal abscess associated with drug abuse after passage of HB1 legislation regulating prescriptions of controlled medications in Kentucky. This increased incidence may be related to individuals relying on nonprescription drugs of abuse due to more highly regulated access to controlled prescription medications. However, additional factors unrelated to HB1 legislation must be taken into account.

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Spinal cord abscess in a heroin addict: case report

Cited by 20 publications

References 14 publications

Holocord intramedullary abscess: an unusual case with review of literature

Holocord intramedullary abscess: an unusual case with review of literature

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

Increased Incidence of Spinal Abscess and Substance Abuse after Implementation of State Mandated Prescription Drug Legislation

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