J Korean Med Sci.  2010 Jan;25(1):176-179. 10.3346/jkms.2010.25.1.176.

Cervical Epidural Abscess in Haemodialysis Patients by Catheter Related Infection: Report of Two Cases

• Gezici AR
• Ergun R

• KMID: 1713854
• DOI: http://doi.org/10.3346/jkms.2010.25.1.176

Abstract

Despite advances in neuroimaging and neurosurgical treatment modalities, spinal epidural abscess remains a challenging problem. Early diagnosis is often difficult and treatment is always delayed. Spinal epidural abscess usually develops in patients with predisposing factors such as IV drug abuse, senillity, diabetes mellitus, spinal attempts, alcoholism, immunosuppression, liver diseases and catheterizations. It is rarely seen in cervical region. A successful treatment is only possible with early diagnosis and accurate surgical and medical treatment. Optimal management is unclear and morbidity and mortality are significant. We present two adult haemodialysis patients with end-stage renal insufficiency who developed cervical epidural abscess following central venous catheter placement. Early surgical intervention is mandatory in cases those have progressive neurological deficit and spinal deformity, and this is also increases the success rate of medical therapy.

Keyword

Epidural Abscess; Catheterization; Therapeutics; Vertebral Osteomyelitis

MeSH Terms

Aged
Anti-Bacterial Agents/therapeutic use
Catheterization, Central Venous
*Cervical Vertebrae
Epidural Abscess/*diagnosis/surgery
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Pseudomonas Infections/diagnosis
Renal Dialysis
Staphylococcal Infections/diagnosis
Anti-Bacterial Agents

Figure

• 

  Fig. 1 Sagittal postgadolinium T1-weighted MR image revealed an epidural abscess at C4-5 level in cervical region (case 1).

• 

  Fig. 2 Sagittal postgadolinium T1-weighted MR image revealed epidural abscess, spondylodiscitis and anterior kyphotic deformity with cord compression in C5 to C7 levels (case 2).

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