Spinal Epidural Abscess: Case Report and Review of the Literature

脊髓硬膜下膿瘍：一病例報告

李佳舫(Chia-Fang Lee) ； 蘇真真(Jen-Jen Su)

《重症醫學雜誌》 12卷3期 (2011/08) Pp. 129-134

https://doi.org/10.30035/TCCM.201108.0006

摘要

髓硬膜下膿瘍是一種少見的感染疾病。如果沒有及早診斷和治療，預後並不佳。脊髓硬膜下膿瘍比較會在一些免疫不佳的狀況，譬如濫用藥物，腎功能不佳，後天免疫不全，癌症，接受免疫抑制劑以及糖尿病患發生。發熱，背痛以及神經學症狀是脊髓硬膜下膿瘍常見的三個症狀; 輔以顯影劑的核磁共振影像檢查是診斷脊髓硬膜下膿瘍最好的方法；開刀引流膿瘍及抗生素治療是當今治療的選擇。我們報告一位五十八歲的糖尿病患因頸部疼痛和左上臂麻木而求診，頸部核磁共振影像檢查顯現一長段脊髓硬膜下膿瘍。病人接受開刀引流膿瘍及抗生素治療後，並輔以復健後出院。

關鍵字

脊髓硬膜下膿瘍 ； 脊髓壓迫病變 ； 椎間盤炎

並列摘要

Spinal epidural abscess (SEA) is a rare disease with poor prognosis if not diagnosed and treated early. It typically occurs at the presence of predisposing conditions including diabetes mellitus, intravenous drug abuse, immunosuppressive therapy, cancer, renal failure and HIV infection. Back pain, fever and neurological deficit are usually considered the classical triads of symptoms. Contrast-enhanced magnetic resonance image is currently the gold standard for the diagnosis of SEA. A combination of surgical drainage of abscess and prolonged antimicrobial therapy has been considered as the treatment of choice. We reported a 58-year-old woman who admitted due to neck pain then upper limb numbness and weakness. Cervical magnetic resonance imaging revealed a cervical epidural abscess. Treatment including surgical drainage and evacuation of spinal abscess and intravenous antibiotics ameliorated the neurological deficits.

並列關鍵字

Spinal epidural abscess (SEA) ； Spinal cord compression ； Spondylodiskitis