Spinal epidural abscess - Revision history

Aidan at 03:03, 10 December 2021

2021-12-10T03:03:10Z

← Older revision		Revision as of 03:03, 10 December 2021
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	* Injection drug use (10%)		* Injection drug use (10%)
	* Other sources including epidural catheters (8%)		* Other sources including epidural catheters (8%)
	* Bone and joint infections (7%)		* Bone and joint infections (7%), including decubitus ulcers
	* Urinary tract (3%)		* Urinary tract (3%)
	* Upper respiratory tract (3%)		* Upper respiratory tract (3%)
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	* Abdomen (2%)		* Abdomen (2%)
	* Intravascular catheter (<1%)		* Intravascular catheter (<1%)

			=== Risk Factors ===

			* [[Diabetes mellitus]] (present in 50%)
			* Injection drug use
			* Spinal surgery or procedure

	==Clinical Manifestations==		==Clinical Manifestations==
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	*Intravenous antibiotics, ideally after blood cultures are drawn		*Intravenous antibiotics, ideally after blood cultures are drawn
	*Typical empiric antibiotics are [[Is treated by::ceftriaxone]] and [[Is treated by::vancomycin]]		*Typical empiric antibiotics are [[Is treated by::ceftriaxone]] and [[Is treated by::vancomycin]]
			*Duration typically 6 to 8 weeks after source control
			*Patients treated non-operatively may need to have antibiotics continued to radiographic resolution of the abscess

	[[Category:CNS infections]]		[[Category:CNS infections]]

Aidan: /* Microbiology */

2021-12-10T02:37:35Z

Microbiology

← Older revision		Revision as of 02:37, 10 December 2021
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	*Fungal or parasitic (1%)		*Fungal or parasitic (1%)
	*Unknown (6%)		*Unknown (6%)
			*[[Tuberculosis]], in endemic countries

	=== Etiologies ===		=== Etiologies ===

Aidan at 02:37, 10 December 2021

2021-12-10T02:37:10Z

@@ Line 7: / Line 7: @@
 ===Microbiology===
-*[[Staphylococcus aureus]] is most common cause
+*[[Staphylococcus aureus]] is most common cause (63%)
 ==Clinical Manifestations==

Aidan at 13:56, 20 February 2021

2021-02-20T13:56:22Z

← Older revision		Revision as of 13:56, 20 February 2021
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	*Typical empiric antibiotics are [[Is treated by::ceftriaxone]] and [[Is treated by::vancomycin]]		*Typical empiric antibiotics are [[Is treated by::ceftriaxone]] and [[Is treated by::vancomycin]]

	[[Category:Infectious diseases]]
	[[Category:Bone and joint infections]]
	[[Category:CNS infections]]		[[Category:CNS infections]]

Aidan at 13:55, 20 February 2021

2021-02-20T13:55:06Z

← Older revision		Revision as of 13:55, 20 February 2021
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	==Background==		==Background==

	*Infection of the epidural space, between the dura mater and bone		*Infection of the epidural space, between the dura mater and bone, in the spine
	*May be intracranial or spinal, with spinal being far more common
	*Acquired from contiguous spread (e.g. discitis, otitis media/sinusitis/mastoiditis, direct inoculation (e.g. spinal anaesthesia or neurosurgery), or hematogenous spread		*Acquired from contiguous spread (e.g. discitis, otitis media/sinusitis/mastoiditis, direct inoculation (e.g. spinal anaesthesia or neurosurgery), or hematogenous spread
	*Risk factors include intravenous drug use, [[hemodialysis]], [[diabetes mellitus]], and older age		*Risk factors include intravenous drug use, [[hemodialysis]], [[diabetes mellitus]], and older age
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	*Neurologic deficits associated with mass effect on spinal cord, interruption of arterial supply, venous thrombosis, or toxin		*Neurologic deficits associated with mass effect on spinal cord, interruption of arterial supply, venous thrombosis, or toxin

	=== Staging of Spinal Epidural Abscess ===		===Staging of Spinal Epidural Abscess===

	* Stage 1: back pain at the level of the affected spine		*Stage 1: back pain at the level of the affected spine
	* Stage 2: nerve-root pain radiating from the involved spinal area		*Stage 2: nerve-root pain radiating from the involved spinal area
	* Stage 3: motor weakness, sensory deficit, and bladder and bowel dysfunction		*Stage 3: motor weakness, sensory deficit, and bladder and bowel dysfunction
	* Stage 4: paralysis		*Stage 4: paralysis

	==Diagnosis==		==Diagnosis==

Aidan: Aidan moved page Epidural abscess to Spinal epidural abscess without leaving a redirect

2021-02-20T13:54:36Z

Aidan moved page Epidural abscess to Spinal epidural abscess without leaving a redirect

← Older revision	Revision as of 13:54, 20 February 2021
(No difference)

Aidan at 13:54, 20 February 2021

2021-02-20T13:54:12Z

← Older revision		Revision as of 13:54, 20 February 2021
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	== Background ==		==Background==

	* Infection of the epidural space, between the dura mater and bone		*Infection of the epidural space, between the dura mater and bone
	* May be intracranial or spinal, with spinal being far more common		*May be intracranial or spinal, with spinal being far more common
	* Acquired from contiguous spread (e.g. discitis, otitis media/sinusitis/mastoiditis, direct inoculation (e.g. spinal anaesthesia or neurosurgery), or hematogenous spread		*Acquired from contiguous spread (e.g. discitis, otitis media/sinusitis/mastoiditis, direct inoculation (e.g. spinal anaesthesia or neurosurgery), or hematogenous spread
	* Risk factors include intravenous drug use, [[hemodialysis]], [[diabetes mellitus]], and older age		*Risk factors include intravenous drug use, [[hemodialysis]], [[diabetes mellitus]], and older age

	=== Microbiology ===		===Microbiology===

	* [[Staphylococcus aureus]] is most common cause		*[[Staphylococcus aureus]] is most common cause

	== Clinical Manifestations ==		==Clinical Manifestations==

	* Severe low-back pain often worse with palpation		*Severe low-back pain often worse with palpation
	* Fever		*Fever
	* Malaise		*Malaise
	* Neurologic deficits associated with mass effect on spinal cord, interruption of arterial supply, venous thrombosis, or toxin		*Neurologic deficits associated with mass effect on spinal cord, interruption of arterial supply, venous thrombosis, or toxin

			=== Staging of Spinal Epidural Abscess ===
	== Diagnosis ==

			* Stage 1: back pain at the level of the affected spine
⚫	* Usually made by MRI (or CT with contrast)
			* Stage 2: nerve-root pain radiating from the involved spinal area
⚫	* Blood cultures may be helpful
			* Stage 3: motor weakness, sensory deficit, and bladder and bowel dysfunction
⚫	* Cultures from the abscess fluid, if possible
			* Stage 4: paralysis

	== ~~Management~~ ==		==Diagnosis==

		⚫	*Usually made by MRI (or CT with contrast)
⚫	* May need urgent neurosurgical drainage if neurological symptoms
		⚫	*Blood cultures may be helpful
⚫	* Intravenous antibiotics, ideally after blood cultures are drawn
		⚫	*Cultures from the abscess fluid, if possible
⚫	* Typical empiric antibiotics are [[Is treated by::ceftriaxone]] and [[Is treated by::vancomycin]]

			==Management==

		⚫	*May need urgent neurosurgical drainage if neurological symptoms
		⚫	*Intravenous antibiotics, ideally after blood cultures are drawn
		⚫	*Typical empiric antibiotics are [[Is treated by::ceftriaxone]] and [[Is treated by::vancomycin]]

	[[Category:Infectious diseases]]		[[Category:Infectious diseases]]

Aidan: Created page with "== Background == * Infection of the epidural space, between the dura mater and bone * May be intracranial or spinal, with spinal being far more common * Acquired from contigu..."

2020-08-18T12:03:28Z

Created page with "== Background == * Infection of the epidural space, between the dura mater and bone * May be intracranial or spinal, with spinal being far more common * Acquired from contigu..."

New page

== Background ==

* Infection of the epidural space, between the dura mater and bone
* May be intracranial or spinal, with spinal being far more common
* Acquired from contiguous spread (e.g. discitis, otitis media/sinusitis/mastoiditis, direct inoculation (e.g. spinal anaesthesia or neurosurgery), or hematogenous spread
* Risk factors include intravenous drug use, [[hemodialysis]], [[diabetes mellitus]], and older age

=== Microbiology ===

* [[Staphylococcus aureus]] is most common cause

== Clinical Manifestations ==

* Severe low-back pain often worse with palpation
* Fever
* Malaise
* Neurologic deficits associated with mass effect on spinal cord, interruption of arterial supply, venous thrombosis, or toxin

== Diagnosis ==

* Usually made by MRI (or CT with contrast)
* Blood cultures may be helpful
* Cultures from the abscess fluid, if possible

== Management ==

* May need urgent neurosurgical drainage if neurological symptoms
* Intravenous antibiotics, ideally after blood cultures are drawn
* Typical empiric antibiotics are [[Is treated by::ceftriaxone]] and [[Is treated by::vancomycin]]

[[Category:Infectious diseases]]
[[Category:Bone and joint infections]]
[[Category:CNS infections]]