Bacterial Spinal Epidural and Psoas Abscess in Pregnancy Associated with Intravenous Drug Use
Spontaneous spinal epidural abscess (SEA) is a rare infection of the central nervous system. We report a case of a 25-year-old G3 P0020 at 36 weeks of gestational age with history of intravenous drug abuse presenting with acute-onset and severe back pain. Despite antibiotic therapy, pain worsened an...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Case Reports in Obstetrics and Gynecology |
| Online Access: | http://dx.doi.org/10.1155/2018/1797421 |
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| author | Tirtza N. Spiegel Strauss Sarah L. Pachtman Burton Rochelson |
| author_facet | Tirtza N. Spiegel Strauss Sarah L. Pachtman Burton Rochelson |
| author_sort | Tirtza N. Spiegel Strauss |
| collection | DOAJ |
| description | Spontaneous spinal epidural abscess (SEA) is a rare infection of the central nervous system. We report a case of a 25-year-old G3 P0020 at 36 weeks of gestational age with history of intravenous drug abuse presenting with acute-onset and severe back pain. Despite antibiotic therapy, pain worsened and she developed lower extremity weakness. Magnetic resonance imaging (MRI) revealed an SEA, and cesarean delivery was performed secondary to increasing weakness, followed by laminectomy (T9-12) and decompression of epidural abscess. Postoperative course was complicated by a psoas muscle abscess and persistent SEA refractory to antibiotic therapy, requiring surgical reexploration and extended treatment with antibiotics. She was discharged home in stable condition and neonate did well with no resulting sequelae. Spinal epidural and psoas abscesses are rare and diagnosis is often delayed. Prompt recognition and treatment are necessary to prevent catastrophic neurologic consequences, and the diagnosis should be considered in pregnant patients presenting with back pain, especially in those with risk factors. |
| format | Article |
| id | doaj-art-c6b6c5cc7ba442c88b06eea0a085b189 |
| institution | Kabale University |
| issn | 2090-6684 2090-6692 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Obstetrics and Gynecology |
| spelling | doaj-art-c6b6c5cc7ba442c88b06eea0a085b1892025-02-03T07:24:54ZengWileyCase Reports in Obstetrics and Gynecology2090-66842090-66922018-01-01201810.1155/2018/17974211797421Bacterial Spinal Epidural and Psoas Abscess in Pregnancy Associated with Intravenous Drug UseTirtza N. Spiegel Strauss0Sarah L. Pachtman1Burton Rochelson2Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, North Shore University Hospital, Manhasset, NY, USADivision of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, North Shore University Hospital, Manhasset, NY, USADivision of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, North Shore University Hospital, Manhasset, NY, USASpontaneous spinal epidural abscess (SEA) is a rare infection of the central nervous system. We report a case of a 25-year-old G3 P0020 at 36 weeks of gestational age with history of intravenous drug abuse presenting with acute-onset and severe back pain. Despite antibiotic therapy, pain worsened and she developed lower extremity weakness. Magnetic resonance imaging (MRI) revealed an SEA, and cesarean delivery was performed secondary to increasing weakness, followed by laminectomy (T9-12) and decompression of epidural abscess. Postoperative course was complicated by a psoas muscle abscess and persistent SEA refractory to antibiotic therapy, requiring surgical reexploration and extended treatment with antibiotics. She was discharged home in stable condition and neonate did well with no resulting sequelae. Spinal epidural and psoas abscesses are rare and diagnosis is often delayed. Prompt recognition and treatment are necessary to prevent catastrophic neurologic consequences, and the diagnosis should be considered in pregnant patients presenting with back pain, especially in those with risk factors.http://dx.doi.org/10.1155/2018/1797421 |
| spellingShingle | Tirtza N. Spiegel Strauss Sarah L. Pachtman Burton Rochelson Bacterial Spinal Epidural and Psoas Abscess in Pregnancy Associated with Intravenous Drug Use Case Reports in Obstetrics and Gynecology |
| title | Bacterial Spinal Epidural and Psoas Abscess in Pregnancy Associated with Intravenous Drug Use |
| title_full | Bacterial Spinal Epidural and Psoas Abscess in Pregnancy Associated with Intravenous Drug Use |
| title_fullStr | Bacterial Spinal Epidural and Psoas Abscess in Pregnancy Associated with Intravenous Drug Use |
| title_full_unstemmed | Bacterial Spinal Epidural and Psoas Abscess in Pregnancy Associated with Intravenous Drug Use |
| title_short | Bacterial Spinal Epidural and Psoas Abscess in Pregnancy Associated with Intravenous Drug Use |
| title_sort | bacterial spinal epidural and psoas abscess in pregnancy associated with intravenous drug use |
| url | http://dx.doi.org/10.1155/2018/1797421 |
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