胸椎硬膜外脓肿1例报告

患者,男,３８岁。胸背部疼痛１０天伴双下肢瘫,大小便困难３天,于１９９５－０１－０９入院。入院２０天前,腰骶部患疖病。体检：患者抬入病房,Ｔ９－Ｔ１２棘突叩击痛,脐以下痛觉消失,腹壁反射消失,马鞍区感觉麻木,提睾反射及肛门反射消失,双下肢肌张力增高,肌力３级,膝跟腱反射亢进,踝阵挛阳性巴彬斯基征阳性。Ｘ线平片Ｔ７－Ｌ２未见异常。ＣＴ示Ｔ９－１０椎管内０６ｃｍ×０．８ｃｍ大小的类圆形高密度影。体温３６９℃,白细胞２４３×１０９／Ｌ,分叶０９,淋巴　收稿日期：１９９９０２１５０１,血沉…     

自发性颈椎管硬膜外脓肿1例报告

患者男性,61岁。入院前3d前因“晨起后发觉颈部僵硬不适”,于当地诊所行按摩、拔罐、针灸治疗,无明显改善;2d前出现四肢无力,于当地县医院就诊考虑脑血管病变予以改善循环输液治疗,症状无改善;1d前突发高热,达40℃,24h后体温降至正常,四肢肌力明显减弱,不能站立行走,大小便障碍。行头部CT检查未见异常;     

不典型巨大硬膜外脓肿1例报告

脊髓硬膜外脓肿(spinal epidural abscess,SEA)是指发生在硬膜外间隙的化脓性感染,因其聚集大量脓液,使得相应的脊髓受压而出现一系列神经障碍表现疾病。本院收治1例T9~S5节段的金黄色葡萄球菌感染引起的巨大硬膜外脓肿1例,现将其诊断及治疗体会分析讨论。     

腰椎椎管内布氏杆菌脓肿1例报告

患者男性,41岁。2个月前搬重物时不慎扭伤腰部,伤后即感觉腰部疼痛不适,3d后疼痛加重,在当地医院行CT检查,诊断为“腰椎间盘突出症”,行腰部痛点封闭治疗,共进行3次,具体用药及剂量不详,疼痛有所缓解。封     

不典型胸椎管内硬膜外脓肿1例报告

患者女性,39岁.因胸背痛20d、加重伴双下肢乏力1d于2007年6月1日入院.患者3周前有手外伤感染病史(已治愈),1周前有"感冒"病史.查体:体温36.7℃,T6棘突右侧有一约4×5 cm的包块,质软,边界清,无明显压痛,胸腰段棘突无明显压痛,胸椎中段有叩击痛,左下肢肌力3级,右下肢肌力1级,平脐水平以下皮肤感觉消失,双侧腹壁反射、膝腱反射和肛门反射消失,肛周、会阴部感觉明显减退,双侧Babinski's征(-).     

脾脓肿1例报告

脾脓肿１例报告黄豫福建省沙县医院外科（沙县３６５５００）患者男性，４６岁，农民。主诉：左肾区疼痛阵发性加剧伴畏寒发热，时有寒战１０余日，于１９８９年８月３１日首次入院。查体：Ｔ３７．８℃，ＷＢＣ９．２ｘ１０９／Ｌ，Ｎ０．７８，Ｌ０．２２，Ｈｂ９０ｇ／...     

脐尿管脓肿1例报告

患者，男，31对岁。发现下腹部肿块伴尿路刺激症状子1993年5月9日入院。体检：下腹部触及一8cm×6cm肿块，质软，无触痛。B超及CT扫描均发现膀胱前上方肿块。膀胱镜检查见膀胱顶部有一鸡蛋大小肿块向膀胱内突出，镜下活检未见明显异常。于5月20日行手术探查。术中见肿块呈囊性，与周围组织界限清楚。切除肿块送冰冻切片检查报告为脐尿管脓肿，术后10d痊愈出院。随访3年尚健在。讨论脐尿管系尿囊腔退化、闭锁而形成的一个纤维肌京，位于脐与膀航顶部之间，既可产生感染，亦可发生原发性肿瘤。有关脐尿管脓肿的报告较少见。本病在临床上主要…     

硬膜外腔冲洗治疗针刺并发硬膜外脓肿二例报告

临床资料例１患者男，５３岁，渔民，因腰痛并向下肢放射痛１月余，在当地卫生院针灸治疗后症状加重，且伴Ｔ１２以下出现麻胀痛感及发热，遂以椎间盘突出症住院治疗，在行腰椎管内造影过程中发现穿刺针进入硬膜腔后回抽有脓性物，ＣＴ检查提示Ｌ１～５椎管内有积液占位。...     

胸椎巨大脊髓硬膜外脓肿合并不全瘫1例报告

脊髓硬膜外脓肿(SEA)是一种罕见的中枢神经系统化脓性感染,局限在头颅或椎管内的脓肿可压迫脑或脊髓,可引起神经损伤,严重者甚至导致死亡[1].及时的诊断和治疗可缓解病症及防止并发症的发生.2020年8月22日,本院收治1例胸椎巨大多灶性脊髓硬膜外脓肿患者,治疗效果满意,现报告如下.     

Cervical spinal epidural abscess: case report

Most cases of spinal epidural abscesses occur in a midthoracic or lower lumbar location. Cervical spinal epidural abscess is distinctly rare, and its prognosis is not favorable due to respiratory problems. We report a case of cervical spinal epidural abscess. A 77-year-old male was admitted because of tetraparesis and dyspnea. Two months before admission, he had been treated by femoro-femoral bypass for arteriosclerosis obliterans , and he had suffered from postoperative wound infection one month later. He had noticed neck pain two days before admission, followed by a numbness and motor weakness in both hands. Neurological examination showed flaccid tetraplegy with an absence of DTRs, paralysis of intercostal muscles, loss of sensation below the C4 dermatome, and bladder dysfunction. A spinal CT scan revealed a mass lesion in the anterior epidural space from C2 to C6, which displaced the spinal cord posteriorly. A myelogram showed complete blockage of contrast medium at the level of C7-T1. He was treated by emergency laminectomy of C3 to C6 with evacuation of the epidural abscess. Culture showed staphylococcus aureus, for which appropriate antibiotics were administered. In spite of such an intensive treatment, the patient showed poor neurological improvement and died 42 days after operation.     

慢性自发性腰椎管内硬膜外血肿1例

正患者,男,77岁,因"腰痛伴双下肢麻木、疼痛、无力8年,加重2个月"于2016年11月7日入院。患者8年前腰痛,伴双下肢麻木、无力,间歇性跛行,2个月前无明显诱因出现腰痛明显加重伴双侧臀部疼痛,站立行走时疼痛明显,并伴尿频、尿急。查体:腰背部压痛、叩痛明显,伴双侧臀部放射痛,腰椎屈伸活动受限明显,右小腿及足部针刺觉减弱,双侧胫前肌肌力Ⅳ级,双拇趾背伸肌力Ⅲ级,双足跖屈肌力     

Brucellar spondylo-discitis with rapidly progressive spinal epidural abscess presenting with sciatica

STUDY DESIGN: Case report. OBJECTIVE: To present a patient with spinal brucellosis, which was initially presented with sciatica and misdiagnosed as a lumbar disc herniation owing to nonspecific neurological and radiological findings. The delay in diagnosis led to rapid progression of the disease and complications. SETTING: Department of Neurosurgery at a tertiary university teaching hospital (Sutcu Imam University Medical Center in Turkey). CASE REPORT: A 57-year-old woman with a history of low-back pain for 6 months, fatigue, and severe left-sided sciatica for the last 3 months presented to our hospital. Three months earlier, at another hospital, she had had a negative Rose-Bengal test for brucellosis and a lumbar computed tomography performed at that time showed only minimal L4-5 annular bulging. For 2 months, she was treated with analgesics for 'lumbar disc herniation' without relief of pain. On presentation to our department, her magnetic resonance imaging (MRI) examination showed edema and minimal annular bulging at L3-4 and L4-5. When her Rose-Bengal test returned positive, she was started on triple antibiotics for presumed Brucella infection. When symptoms and neurologic signs worsened while taking antibiotics, repeat MRI scan showed a spinal epidural abscess at the L4-5 level. Emergent surgery and 8 weeks of antibiotics resulted in cure. CONCLUSION: In areas endemic for brucellosis, subtle historical and exam features should be sought to exclude an infection such as brucellar sponylo-discitis. Appropriate serological tests should be readily available to confirm or exclude this diagnosis in selected patients, to avoid delays in antibiotic treatment.     

Sterile recurrent spinal epidural abscess in a patient with Crohn's disease: a case report

BACKGROUND: The frequency of SEA is increasing. There are several well-established predisposing factors. CASE DESCRIPTION: Our case presents certain unusual features that include an association with CD, persistent sterile cultures, and multiple recurrences of lesions at adjacent levels. CONCLUSIONS: A review of the literature showed only 13 case reports of SEA in patients with CD with an additional patient mentioned in one series. Recurrence of SEA at the same location was reported only twice. The diagnostic workup and treatment modalities pertinent to this case are discussed.     

Anaerobic spinal epidural abscess. Case report

An acute spinal epidural abscess is reported from which a pure growth of the anaerobe Fusobacterium necrophorum was isolated. The mode of infection and pathogen makes it unique. The literature concerning the bacteriology of epidural abscess and the implications of anaerobic epidural infection are discussed.     

Fungal spinal epidural abscess: a case series of nine patients

BACKGROUND CONTEXT

Fungal spinal epidural abscess (FSEA) is a rare entity with high morbidity and mortality. Reports describing the clinical features, diagnosis, treatment, and outcomes of FSEA are scarce in the literature.