Spinal epidural abscess caused by group G streptococci

Klygis, Linas M.; Reisberg, Boris E.

doi:10.1016/0002-9343(91)90078-c

Cited by 16 publications

(2 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[34] The prevalent observation regarding elevated superoxide generation in LAP neutrophils is elevated levels of DAG and reduced levels of DAG kinase in the neutrophils from LAP patients. [35]…”

Section: Discussionmentioning

confidence: 99%

Assessment of peripheral neutrophil functions in patients with localized aggressive periodontitis in the Indian population

Bhansali

Yeltiwar

Bhat³

2013

J Indian Soc Periodontol

View full text Add to dashboard Cite

Background:Localized aggressive periodontitis (LAP) patients exhibit abnormal neutrophil functions to a variety of environmental and host stimuli. The aim of the present study was to evaluate neutrophils chemotaxis, phagocytosis, microbicidal activity and superoxide generation in LAP patients of Indian origin.Materials and Methods:Eleven LAP patients and nine healthy subjects were included in the study. Neutrophil chemotaxis was evaluated against an alkali-soluble casein solution using Wilkinson's method. Phagocytosis and microbicidal activity assay were performed using Candida albicans as an indicator organism. Nitrobluetetrazolium (NBT) test was used to assess superoxide generation by neutrophils using E. coli endotoxin.Results:The chemotactic activity and phagocytic and microbicidal activity were observed to be significantly reduced (P < 0.01) in LAP neutrophils. On the contrary, superoxide generation was observed to be significantly increased (P < 0.01) in LAP neutrophils compared with healthy individuals.Conclusion:The results of the present study suggest that neutrophil functions, namely chemotaxis, phagocytosis and microbicidal activity, are deficient LAP patients. However, superoxide generation was significantly increased when stimulated by endotoxins, which may explain the tissue damage seen in LAP. These abnormal neutrophil functions may predispose to increased susceptibility for LAP. Further large-scale studies are required in the Indian population to ascertain the cause-and-effect relationship of defective host factors and aggressive periodontitis and to develop treatment strategies for more predictable periodontal treatment outcome.

show abstract

Section: Discussionmentioning

confidence: 99%

Assessment of peripheral neutrophil functions in patients with localized aggressive periodontitis in the Indian population

Bhansali

Yeltiwar

Bhat³

2013

J Indian Soc Periodontol

View full text Add to dashboard Cite

show abstract

“…Ten of 854 patients in the literature developed SEA during pregnancy or the postpartal period [16,70,122,160,176,182,185,224]. Postpartal impairment of immune defense may be related to the development of SEA in these patients [224].…”

Section: Pathogenesis and Risk Factorsmentioning

confidence: 99%

Spinal epidural abscess: a meta-analysis of 915 patients

Waldbaur²,

2000

View full text Add to dashboard Cite

Spinal epidural abscess (SEA) was first described in the medical literature in 1761 and represents a severe, generally pyogenic infection of the epidural space requiring emergent neurosurgical intervention to avoid permanent neurologic deficits. Spinal epidural abscess comprises 0.2 to 2 cases per 10,000 hospital admissions. This review intends to offer detailed evaluation and a comprehensive meta-analysis of the international literature on SEA between 1954 and 1997, especially of patients who developed it following anesthetic procedures in the spinal canal. In this period, 915 cases of SEA were published. This review is the most comprehensive literature analysis on SEA to date. Most cases of SEA occur in patients aged 30 to 60 years, but the youngest patient was only 10 days old and the oldest was 87. The ratio of men to women was 1:0.56. The most common risk factor was diabetes mellitus, followed by trauma, intravenous drug abuse, and alcoholism. Epidural anesthesia or analgesia had been performed in 5.5% of the patients with SEA. Skin abscesses and furuncles were the most common source of infection. Of the patients, 71% had back pain as the initial symptom and 66% had fever. The second stage of radicular irritation is followed by the third stage, with beginning neurological deficit including muscle weakness and sphincter incontinence as well as sensory deficits. Paralysis (the fourth stage) affected only 34% of the patients. The average leukocyte count was 15,700/microl (range 1,500-42,000/microl), and the average erythrocyte sedimentation rate was 77 mm in the first hour (range 2-50 mm). Spinal epidural abscess is primarily a bacterial infection, and the gram-positive Staphylococcus aureus is its most common causative agent. This is true also for patients who develop SEA following spinal anesthetics. Magnetic resonance imaging (MRI) displays the greatest diagnostic accuracy and is the method of first choice in the diagnostic process. Myelography, commonly used previously to diagnose SEA, is no longer recommended. Lumbar puncture to determine cerebrospinal fluid protein concentrations is not needed for diagnosis and entails the risk of spreading bacteria into the subarachnoid space with consequent meningitis; therefore, it should not be performed. The therapeutic method of choice is laminectomy combined with antibiotics. Conservative treatment alone is justifiable only for specific indications. Laminotomy is a therapeutic alternative for children. The mortality of SEA dropped from 34% in the period of 1954-1960 to 15% in 1991-1997. At the beginning of the twentieth century, almost all patients with SEA died. Parallel to improvements in the mortality rate, today more patients experience complete recovery from SEA. The prognosis of patients who develop SEA following epidural anesthesia or analgesia is not better than that of patients with noniatrogenic SEA, and the mortality rate is also comparable. The essential problem of SEA lies in the necessity of early diagnosis, because only timely treatment is able to av...

show abstract

Spinal Epidural Abscess

Maslen¹

1993

Arch Intern Med

View full text Add to dashboard Cite

The medical literature regarding spinal epidural abscess has two common threads: reports of poor prognosis and appeals for rapid treatment. Spinal epidural abscess is a difficult diagnosis to make because of its rarity--many physicians will never see a case during their careers. Among all patients admitted to hospitals, the incidence is approximately one to two cases per 10,000. Only increased awareness and swift management of spinal epidural abscess will improve outcome. Our goal through this report is to enhance the recognition and treatment of spinal epidural abscess. We present 28 new cases of spinal epidural abscess, giving special attention to the peculiarities of the disease; we compile and analyze comprehensive data from cases from literature; and finally, we present the results of 16 retrospective personal interviews of infected patients.

show abstract

Spinal epidural abscess caused by group G streptococci

Cited by 16 publications

References 13 publications

Assessment of peripheral neutrophil functions in patients with localized aggressive periodontitis in the Indian population

Assessment of peripheral neutrophil functions in patients with localized aggressive periodontitis in the Indian population

Spinal epidural abscess: a meta-analysis of 915 patients

Spinal Epidural Abscess

Contact Info

Product

Resources

About