ACUTE FEBRILE ILLNESS PRESENTING AS DIABETIC KETOACIDOSIS AND DEEP VEIN THROMBOSIS FINALLY DIAGNOSED AS CERVICOTHORACIC SPINAL EPIDURAL ABSCESS: CASE REPORT AND REVIEW OF LITERATURE
Abstract
Classically, diagnosis of spinal epidural abscess can be made when the triad of symptoms of backache,
fever and neurological deterioration are present. But often, presentations can be varied. In this case, a 50
year old male presented with diabetic ketoacidosis and fever , who did not have the conventional symptoms and was
subsequently diagnosed with cervicothoracic spinal epidural abscess measuring 17 cm in length after neurological
deterioration and was managed by decompressive laminectomy and antibiotics. Expeditious diagnosis and suitable treatment
strategies are the need of the hour for preventing lifelong neurological decits in the patients.
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Hlavin, M. L., Kaminski, H. J., Ross, J. S., & Ganz, E. (1990). Spinal epidural abscess: a ten-year perspective. Neurosurgery, 27(2), 177-184. Spinal Epidural Abscess: A Ten-Year Perspective : Neurosurgery (lww.com)
Vakili, M., & Crum-Cianflone, N. F. (2017). Spinal epidural abscess: a series of 101 cases. The American journal of medicine, 130(12), 1458-1463. https://doi.org/10.1016/j.amjmed.2017.07.017
Lane, T., Goings, S., Fraser, D. W., Ries, K., Pettrozzi, J., & Abrutyn, E. (1979). Disseminated actinomycosis with spinal cord compression: report of two cases. Neurology, 29(6), 890-890. https://doi.org/10.1212/WNL.29.6.890
Baker, A. S., Ojemann, R. G., Swartz, M. N., & Richardson Jr, E. P. (1975). Spinal epidural abscess. New England Journal of Medicine, 293(10), 463-468. https://doi.org/ HYPERLINK "https://doi.org/10.1056/NEJM197509042931001"10.1056/NEJM197509042931001
Martin, R. J., & Yuan, H. A. (1996). Neurosurgical care of spinal epidural, subdural, and intramedullary abscesses and arachnoiditis. Orthopedic Clinics of North America, 27(1), 125-136. https://doi.org/10.1016/S0030-5898(20)32057-5
Mackenzie, A. R., Laing, R. B. S., Smith, C. C., Kaar, G. F., & Smith, F. W. (1998). Spinal epidural abscess: the importance of early diagnosis and treatment. Journal of Neurology, Neurosurgery & Psychiatry, 65(2), 209-212. Spinal epidural abscess: the importance of early diagnosis and treatment | Journal of Neurology, Neurosurgery HYPERLINK "https://jnnp.bmj.com/content/65/2/209.info"& HYPERLINK "https://jnnp.bmj.com/content/65/2/209.info" Psychiatry (bmj.com)
Nussbaum, E. S., Rigamonti, D., Standiford, H., Numaguchi, Y., Wolf, A. L., & Robinson, W. L. (1992). Spinal epidural abscess: a report of 40 cases and review. Surgical neurology, 38(3), 225-231. https://doi.org/10.1016/0090-3019(92)90173-K
Rigamonti, D., Liem, L., Wolf, A. L., Fiandaca, M. S., Numaguchi, Y., Hsu, F. P., & Nussbaum, E. S. (1994). Epidural abscess in the cervical spine. The Mount Sinai journal of medicine, New York, 61(4), 357-362. Epidural abscess in the cervical spine. - Abstract - Europe PMC
Davis, D. P., Wold, R. M., Patel, R. J., Tran, A. J., Tokhi, R. N., Chan, T. C., & Vilke, G. M. (2004). The clinical presentation and impact of diagnostic delays on emergency department patients with spinal epidural abscess. The Journal of emergency medicine, 26(3), 285-291. https://doi.org/10.1016/j.jemermed.2003.11.013
Grewal, S., Hocking, G., & Wildsmith, J. A. W. (2006). Epidural abscesses. British journal of anaesthesia, 96(3), 292-302. https://doi.org/10.1093/bja/ael006
Lener, S., Hartmann, S., Barbagallo, G. M., Certo, F., Thomé, C., & Tschugg, A. (2018). Management of spinal infection: a review of the literature. Acta neurochirurgica, 160, 487-496. https://doi.org/10.1007/s00701-018-3467-2
Galli, E., Maggio, E., & Pomero, F. (2022). Venous thromboembolism in sepsis: from bench to bedside. Biomedicines, 10(7), 1651. https://doi.org/10.3390/biomedicines10071651
Do Kim, S., Melikian, R., Ju, K. L., Zurakowski, D., Wood, K. B., Bono, C. M., & Harris, M. B. (2014). Independent predictors of failure of nonoperative management of spinal epidural abscesses. The Spine Journal, 14(8), 1673-1679. https://doi.org/10.1016/j.spinee.2013.10.011
Khanna, R. K., Malik, G. M., Rock, J. P., & Rosenblum, M. L. (1996). Spinal epidural abscess: evaluation of factors influencing outcome. Neurosurgery, 39(5), 958-964. Spinal Epidural Abscess: Evaluation of Factors Influencing O... : Neurosurgery (lww.com)
El Sayed, M., & Witting, M. D. (2011). Low yield of ED magnetic resonance imaging for suspected epidural abscess. The American journal of emergency medicine, 29(9), 978-982. https://doi.org/10.1016/j.ajem.2010.05.004
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