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A Case of Spinal Epidural Abscess Caused by Sreptococcus pneumoniae
Ji-Young Rhee, M.D., Yu-mi Wi, M.D., Kyong-Mok Son, M.D., Hyun-Kyun Ki, M.D., Chi-Sook Moon, M.D. Won Sup Oh, M.D., Kyong Ran Peck, M.D. and Jae-Hoon Song, M.D.
Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea
Vol.36 Num.6 (p386~388)
Pneumonia and meningitis are the most frequent manifestations of pneumococcal infections. Pneumococcal spinal epidural abscesses have been rarely reported. Spinal epidural abscess by Streptococcus pneumoniae has been diagnosed among the patients with diabetes mellitus, alcoholism, corticosteroid therapy, intravenous drug use, chronic renal failure, AIDS, and history of spinal surgery. Recently, we experienced a case of pneumococcal spinal epidural abscess after spinal trauma. A 36-year-old male patient was admitted with back pain, fever, and paraplegia which occurred 5 days after the trauma. Spine MRI revealed spinal epidural abscess at the level from T2 to T9. He was treated with antimicrobial agents and surgical exploration for spinal epidural abscess. Pus culture grew S. pneumoniae which was susceptible to penicillin. Despite early surgical treatment, neurologic sequelae remained. Considering the high mortality and morbidity of pneumococcal spinal epidural abscess, early diagnosis and aggressive treatment including surgical intervention and antibiotics therapy should be implemented immediately.
Keywords : Streptococcus pneumoniae, Spinal epidural abscess, Spinal trauma