Infection and Drug Resistance (Mar 2023)
Acute Spinal Epidural Abscess of the Cervical Spine Caused by Streptococcus constellatus Leads to Paraplegia in an Adult: A Case Report
Abstract
Wen Zhang,1,2,* Yudong Lai,2,* Tao Li,2 Xingpeng Wang,2 Weidong Mu,3,4 Zhensong Jiang2 1Department of Spine Surgery, Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China; 2Department of spine surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People’s Republic of China; 3Department of Traumatic Orthopaedics, Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China; 4Department of Traumatic Orthopaedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zhensong Jiang; Weidong Mu, Email [email protected]; [email protected]: The incidence of a spinal epidural abscess (SEA), which can cause serious neurological complications, is low; however, the incidence of SEA caused by Streptococcus is even lower, most of which are reported in the thoracolumbar spine and lumbosacral segment. We reported a case of cervical SEA caused by Streptococcus constellatus infection, resulting in paralysis of the patient. The acute onset of SEA in a 44-year-old male led to decreased upper limb muscle strength, lower limb paralysis, and loss of bowel and bladder function, and imaging and blood tests suggested pyogenic spondylitis. Emergency decompression surgery and antibiotic therapy were given, the patient gradually recovered, and the muscle strength of the lower limbs gradually improved. This case report suggests the importance of early decompressive surgery and effective antibiotic therapy.Keywords: Streptococcus constellatus, epidural abscess, pyogenic spondylitis, vertebral destruction, diagnosis and treatment
