Document Detail

Epidural abscess caused by Streptococcus milleri in a pregnant woman.
MedLine Citation:
PMID:  16269087     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Bacteria in the Streptococcus milleri group (S. anginosus, S. constellatus, and S. intermedius) are associated with bacteremia and abscess formation. While most reports of Streptococcus milleri group (SMG) infection occur in patients with underlying medical conditions, SMG infections during pregnancy have been documented. However, SMG infections in pregnant women are associated with either neonatal or maternal puerperal sepsis. Albeit rare, S. milleri spinal-epidural abscess in pregnancy has been reported, always as a complication of spinal-epidural anesthesia. We report a case of spinal-epidural abscess caused by SMG in a young, pregnant woman without an antecedent history of spinal epidural anesthesia and without any underlying risk factors for invasive streptococcal disease.
CASE PRESENTATION: A 25 year old pregnant woman developed neurological symptoms consistent with spinal cord compression at 20 weeks gestation. She underwent emergency laminectomy for decompression and was treated with ceftriaxone 2 gm IV daily for 28 days. She was ambulatory at the time of discharge from the inpatient rehabilitation unit with residual lower extremity weakness.
CONCLUSION: To our knowledge, this is the first reported case of a Streptococcus milleri epidural abscess in a healthy, pregnant woman with no history of epidural anesthesia or invasive procedures. This report adds to the body of literature on SMG invasive infections. Treatment of SMG spinal-epidural abscess with neurologic manifestations should include prompt and aggressive surgical decompression coupled with targeted anti-infective therapy.
Russell Lampen; Gonzalo Bearman
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2005-11-03
Journal Detail:
Title:  BMC infectious diseases     Volume:  5     ISSN:  1471-2334     ISO Abbreviation:  BMC Infect. Dis.     Publication Date:  2005  
Date Detail:
Created Date:  2005-11-24     Completed Date:  2006-05-05     Revised Date:  2013-06-07    
Medline Journal Info:
Nlm Unique ID:  100968551     Medline TA:  BMC Infect Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  100     Citation Subset:  IM    
Division of Infectious Diseases, Department of Internal Medicine, Virginia Commonwealth University Medical Center, Richmond, VA, USA.
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MeSH Terms
Anti-Bacterial Agents / therapeutic use
Ceftriaxone / therapeutic use
Epidural Abscess / diagnosis,  drug therapy,  microbiology*,  surgery
Streptococcal Infections / diagnosis,  drug therapy,  microbiology*,  surgery
Streptococcus milleri Group / isolation & purification,  physiology*
Reg. No./Substance:
0/Anti-Bacterial Agents; 73384-59-5/Ceftriaxone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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