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Rehabilitation Practice and Science

Translated Title

菌血症同時併發頸椎硬腦膜上膿瘍及心包膜積水：病例報告

Abstract

Despite advances in neuroimaging technology and neurosurgical treatment, spinal epidural abscess remains a challenging problem. Early diagnosis is difficult and thus treatment is often too late to prevent severe neuro- logical sequelae.A 46 years old male was admitted to our emergency department due to fever and general weakness. Under the impression of sepsis due to Staphylococcus aureus, he was admitted for further antibiotic treatment. Fever subsided one day after parenteral antibiotic usage. Unfortunately, fever recurred three weeks later accompaning with neck pain, cough, dypsnea and skin rash. Chest roentgenogram revealed rapid progressive cardiomegaly. Cardiac ultrasonographic examination noted large amount of pericardial effusion. Therefore, pericardiotomy and effusion drainage were performed. Tetraplegia developed in the next morning. Emergent magnetic resonance imaging (MRI) showed cervical epidural abscess and surgery was performed. The result of bacteria culture from the abscess was the same as the previous blood culture. So secondary hematogeneous spinal infection was diagnosed. The initial presentation of the epidural abscess is often nonspecific. Furthermore, the manifestation of pericarditis can also be neck pain, which makes the concurrent epidural abscess more difficult to be detected and be early treated. This casereport aims at reminding the clinician to keep highly alert when facing the patient with high risk for epidural abscess.

Language

Traditional Chinese

First Page

37

Last Page

43

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