Document Detail

Medical management of spinal epidural abscesses: case report and review.
MedLine Citation:
PMID:  1617070     Owner:  NLM     Status:  MEDLINE    
Although the traditional management of spinal epidural abscesses includes antibiotic therapy and surgical drainage, numerous reports have appeared in the literature that describe a nonsurgical approach. We report the successful nonsurgical management of a case of an extensive spinal epidural abscess in which the patient was closely monitored by serial studies with magnetic resonance imaging. Review of the literature from 1970 to 1990 revealed 37 cases that describe conservative management of spinal epidural abscesses. Despite successful conservative management reported for some cases, sudden neurological deterioration of patients receiving appropriate antibiotic therapy has also occurred. A true index of the success of nonsurgical therapy is difficult to discern since cases may have been selectively reported and unsuccessful attempts at conservative management may have never been reported once a laminectomy was performed. A prospective investigation that includes clearly defined indications for conservative management vs. surgical intervention and that can be studied with an intention-to-treat analysis is needed.
D Wheeler; P Keiser; D Rigamonti; S Keay
Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Clinical infectious diseases : an official publication of the Infectious Diseases Society of America     Volume:  15     ISSN:  1058-4838     ISO Abbreviation:  Clin. Infect. Dis.     Publication Date:  1992 Jul 
Date Detail:
Created Date:  1992-08-06     Completed Date:  1992-08-06     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  9203213     Medline TA:  Clin Infect Dis     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  22-7     Citation Subset:  IM    
Department of Medicine, University of Maryland Medical Center, Baltimore.
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MeSH Terms
Abscess / diagnosis,  therapy*
Anti-Bacterial Agents / therapeutic use
Epidural Space*
Middle Aged
Spinal Cord Diseases / diagnosis,  therapy
Streptococcal Infections / diagnosis,  therapy*
Reg. No./Substance:
0/Anti-Bacterial Agents
Comment In:
Clin Infect Dis. 1992 Jul;15(1):28-9   [PMID:  1617071 ]

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