J Korean Orthop Assoc.  2011 Dec;46(6):528-532.

Spondylodiscitis with Epidural Abscess Caused by Klebsiella pneumoniae

Affiliations
  • 1Department of Orthopaedic Surgery, Kyungpook National University Hospital, Daegu, Korea. wkmin@knu.ac.kr

Abstract

Spondylodiscitis is very rare complication caused by Klebsiella pneumoniae. Among those, few cases of spondylodiscitis concomitant with epidural abscess due to Klebsiella pneumoniae have been reported. We present a case of lumbar pyogenic spondylodiscitis with epidural abscess caused by Klebsiella pneumoniae that successfully treated with administration of cefotaxime, surgical drainage and intermittent closed continuous saline irrigation.

Keyword

spondylodiscitis; spondylitis; epidural abscess; Klebsiella pneumoniae

MeSH Terms

Cefotaxime
Discitis
Drainage
Epidural Abscess
Klebsiella
Klebsiella pneumoniae
Spondylitis
Cefotaxime

Figure

  • Figure 1 (A) Epidural abscess at L2-3 level on sagittal T2 weighted images, which compresses the dura of lumbar spine. Abnormal intensity of L2-3 interverteral disc space was seen. (B) Epidural abscess and the destruction of intervertebral disc at the L2-3 level and Psoas abscess at L3-4 level on axial T2 weighted images. (C) Epidural abscess and the destruction of intervertebral disc at the L2-3 level and Psoas abscess at L3-4 level on axial Gadolinium enhancement images.

  • Figure 2 After the sudden onset of neurologic symptom, emergency follow-up magnetic resonance imaging revealed the increase of epidural abscess at L2-4 level.

  • Figure 3 Draining tube through L2-3 epidural space was seen on the sagittal T2 weighted (A) and the Gadolinium enhanced magnetic resonance imaging (B) 3 days after surgery.


Reference

1. Chevalier X, Marty M, Larget-Piet B. Klebsiella pneumoniae septic arthritis of a lumbar facet joint. J Rheumatol. 1992. 19:1817–1819.
2. Torda AJ, Gottlieb T, Bradbury R. Pyogenic vertebral osteomyelitis: analysis of 20 cases and review. Clin Infect Dis. 1995. 20:320–328.
Article
3. Vorbeck F, Morscher M, Ba-Ssalamah A, Imhof H. Infectious spondylitis in adults. Radiologe. 1996. 36:795–804.
Article
4. Kouroussis C, Georgoulias V, Souglakos J, Simvoulakis E, Karabekios S, Samonis G. Spontaneous spondylodiscitis caused by Klebsiella pneumoniae. Infection. 1999. 27:368–369.
Article
5. Porras JA, Bayona C, Gutiérrez MC, Vidal F. Vertebral osteomyelitis due to Klebsiella pneumoniae. An Med Interna. 1994. 11:154–155.
6. Apple JS, Halvorsen RA, Chapman TM, Martinez S. Klebsiella pneumoniae arthritis of the hip in a diabetic patient. South Med J. 1984. 77:229–231.
Article
7. DelCurling O Jr, Gower DJ, McWhorter JM. Changing concepts in spinal epidural abscess: a report of 29 cases. Neurosurgery. 1990. 27:185–192.
8. Yacoub WN, Sohn HJ, Chan S, Petrosyan M, Vermaire HM, Kelso RL, et al. Psoas abscess rarely requires surgical intervention. Am J Surg. 2008. 196:223–227.
Article
9. Ohara N, Tominaga O, Uchiyama M, Nakano H, Muto T. Primary iliopsoas abscess successfully treated by ultrasonographically guided percutaneous drainage. J Orthop Sci. 1998. 3:221–224.
Article
10. Tofuku K, Koga H, Yone K, Komiya S. Continuous irrigation in pyogenic spondylitis accompanied by iliopsoas abscess. Spine (Phila Pa 1976). 2007. 32:E382–E387.
Article
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