Revista argentina de neurocirugía
versión On-line ISSN 1850-1532
CASTILLO, Guillermo. Absceso epidural espinal: presentación atípica. Rev. argent. neurocir. [online]. 2006, vol.20, n.1, pp. 41-43. ISSN 1850-1532.
Objective: to describe a new case of spinal epidural abscess with an atypical presentation. Description: a female patient with 41 years-old, with a normal previous history and laboratory tests, presented with a 4 months history of bilateral ciatic and back pain. Clinical examination showed a left Lasegue sign. Magnetic resonance showed an image of massive lumbar herniated disc. Intervention: she was taken to surgery and an hemilaminectomy was performed. Only pus was obtained that was positive for stafilococus aureus. Ciatic pain dissapeared but in spite of the antibiotic treatmen back pain persisted. A new magnetic resonance performed 4 weeks later showed signs of spondylodiscitis in L4-L5 and L5-S1. With the antibiotic treatment the images normalized after 6 months. Conclusion. The case seemed to be simple but during surgery the diagnosis was modified. Less frequent pathologies should always be considered. The epidural spinal abscess should be treated as a surgical emergency.
Palabras llave : Discal hernia; Epidural abscess; Magnetic resonance imaging; Spondylodiscitis.