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Query: UMLS:C0030552 (paresis)
 5,831 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Spinal epidural abscess is an infectious disorder with high morbidity and mortality rates, which is often associated with delayed diagnosis. We report a case of a 73-year-old man with cervical pyogenic spondylodiscitis complicated with epidural abscess following a prostatic biopsy. Clinical presentation included fever, malaise, neck rigidity in all axes, minor paresis of the right arm, and gait ataxia. A cervical vertebral magnetic resonance imaging (MRI) scan showed pyogenic spondylodiscitis with an epidural abscess. Blood, urine, and cerebrospinal fluid cultures were sterile. The patient was treated with intravenous vancomycin, metronidazole, and ceftazidime for 4 weeks, and was discharged from the hospital and treated with oral cloxacillin, metronidazole, and cefixime for another 2 weeks. His neurological symptoms disappeared completely, and he walked normally, without support. It is important for clinicians to be alert to symptoms accompanying back pain following a prostatic biopsy and to consider the possibility of a diagnosis of spinal abscess.
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PMID:Is prostatic biopsy as safe as we think? Epidural abscess following prostatic biopsy. 1870 50

Spinal epidural abscess (SEA) is a rare but potentially devastating condition. We noticed an increase in the number of cases of SEA, with the majority in hemodialysis (HD) patients. This prompted a retrospective chart review of all cases of SEA admitted from 2000 to 2005 and a literature search of similar cases. We identified 19 SEA cases treated at Long Island College Hospital during this 6-year period, of which six were on HD: four were dialyzed via catheter, one via arteriovenous fistula, and in one the method of dialysis was not documented. Four patients had bacteremia with Staphylococcus aureus. Four patients presented with paresis or paralysis; only one improved. The mortality rate was 33% (2/6). We found 30 other cases of SEA in patients on HD from the literature. These 36 HD cases were compared with 85 SEA cases that were not on HD (13 from our study and 72 described in two large case series). The mortality rate was noted to be much higher in HD patients (23% [6/26] versus 7% [6/85]). Neurologic deficit at presentation was noted in 47% (17/36) of HD patients versus 69% (59/85) of non-HD patients, but neurologic improvement was higher in non-HD patients (71% [42/59] versus 29% [5/17]). This is the largest literature review of SEA in patients on HD. When compared with non-HD patients, HD patients had a higher mortality rate and were less likely to improve neurologically.
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PMID:Spinal epidural abscess in hemodialysis patients: a case series and review. 2161 87

Spinal epidural abscess (SEA) due to Streptococcus pneumoniae is a rare entity, but it is associated with high mortality. Here, we describe a rare case of pneumococcal SEA in an immunocompetent adult who presented with fever, lower back pain and paresis. Central nervous system examination revealed a decreased power in bilateral lower limbs. Magnetic resonance imaging of the lumbosacral spine showed loculated pus collection in the epidural space at the level of L4-L5 vertebrae. Pus obtained following L4-L5 decompression along with blood cultures grew S. pneumoniae. The patient was treated with clindamycin and cefoperazone-sulbactam for 6 weeks, and no relapse was noted on 11 months follow-up.
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PMID:A rare aetiology of spinal epidural abscess. 3243 86