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Article: Aggressive thoracic actinomycosis complicated by vertebral osteomyelitis and epidural abscess leading to spinal cord compression

TitleAggressive thoracic actinomycosis complicated by vertebral osteomyelitis and epidural abscess leading to spinal cord compression
Authors
Issue Date2000
PublisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.com
Citation
Spine, 2000, v. 25 n. 6, p. 745-748 How to Cite?
AbstractStudy Design. Report of a successfully diagnosed and treated case of spinal cord compression due to epidural actinomycosis. Objective. To illustrate that proper use of imaging strategy can greatly facilitate diagnosis and management of this rare condition. Summary of Background Data. Spinal actinomycosis causing epidural abscess and significant spinal cord compression is an uncommon condition. Although diagnosis is difficult, favorable results are widely reported when specific therapy is instituted. Methods. A 32-year-old Chinese man had extensive dorsal thoracic soft tissue swelling and lower limb weakness. Collapse of the T5 vertebral body was found on plain radiographs with mediastinal infiltrates on chest radiograph. It took magnetic resonance imaging (MRI) to fully delineate the epidural abscess and dorsal muscular abscesses, which were not depicted by computed tomographic (CT) scan. Diagnosis was made by examination of CT-guided aspirate and tissue recovered during surgery by a microbiologist. The patient received high-dose intravenous penicillin and prompt spinal decompression once diagnosis of actinomycosis was confirmed. Results. The dorsal muscular abscesses and upper thoracic epidural abscess resolved rapidly after intravenous antibiotics and surgical drainage. This was well documented by follow-up MRI and the full recovery of motor power and lower limb sensation in the patient. Conclusions. High clinical suspicion and proper use of imaging data led to timely diagnosis of this rare case of mediastinal, epidural, and intramuscular thoracic actinomycosis. Specific antibiotic therapy and timely, well-targeted surgical intervention greatly improve the outcome of this condition.
Persistent Identifierhttp://hdl.handle.net/10722/154133
ISSN
2015 Impact Factor: 2.439
2015 SCImago Journal Rankings: 1.459
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorYung, BCKen_US
dc.contributor.authorCheng, JCKen_US
dc.contributor.authorChan, TTFen_US
dc.contributor.authorLoke, TKLen_US
dc.contributor.authorLo, Jen_US
dc.contributor.authorLau, PYen_US
dc.date.accessioned2012-08-08T08:23:25Z-
dc.date.available2012-08-08T08:23:25Z-
dc.date.issued2000en_US
dc.identifier.citationSpine, 2000, v. 25 n. 6, p. 745-748en_US
dc.identifier.issn0362-2436en_US
dc.identifier.urihttp://hdl.handle.net/10722/154133-
dc.description.abstractStudy Design. Report of a successfully diagnosed and treated case of spinal cord compression due to epidural actinomycosis. Objective. To illustrate that proper use of imaging strategy can greatly facilitate diagnosis and management of this rare condition. Summary of Background Data. Spinal actinomycosis causing epidural abscess and significant spinal cord compression is an uncommon condition. Although diagnosis is difficult, favorable results are widely reported when specific therapy is instituted. Methods. A 32-year-old Chinese man had extensive dorsal thoracic soft tissue swelling and lower limb weakness. Collapse of the T5 vertebral body was found on plain radiographs with mediastinal infiltrates on chest radiograph. It took magnetic resonance imaging (MRI) to fully delineate the epidural abscess and dorsal muscular abscesses, which were not depicted by computed tomographic (CT) scan. Diagnosis was made by examination of CT-guided aspirate and tissue recovered during surgery by a microbiologist. The patient received high-dose intravenous penicillin and prompt spinal decompression once diagnosis of actinomycosis was confirmed. Results. The dorsal muscular abscesses and upper thoracic epidural abscess resolved rapidly after intravenous antibiotics and surgical drainage. This was well documented by follow-up MRI and the full recovery of motor power and lower limb sensation in the patient. Conclusions. High clinical suspicion and proper use of imaging data led to timely diagnosis of this rare case of mediastinal, epidural, and intramuscular thoracic actinomycosis. Specific antibiotic therapy and timely, well-targeted surgical intervention greatly improve the outcome of this condition.en_US
dc.languageengen_US
dc.publisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.comen_US
dc.relation.ispartofSpineen_US
dc.subject.meshActinomycosis - Complications - Diagnosis - Drug Therapyen_US
dc.subject.meshAdulten_US
dc.subject.meshEpidural Abscess - Complications - Diagnosis - Surgeryen_US
dc.subject.meshHumansen_US
dc.subject.meshLaminectomyen_US
dc.subject.meshMagnetic Resonance Imagingen_US
dc.subject.meshMaleen_US
dc.subject.meshOsteomyelitis - Complicationsen_US
dc.subject.meshSpinal Cord Compression - Diagnosis - Etiology - Surgeryen_US
dc.subject.meshSpinal Diseases - Complications - Diagnosis - Surgeryen_US
dc.subject.meshTomography, X-Ray Computeden_US
dc.titleAggressive thoracic actinomycosis complicated by vertebral osteomyelitis and epidural abscess leading to spinal cord compressionen_US
dc.typeArticleen_US
dc.identifier.emailLo, J:drjohnlo@hku.hken_US
dc.identifier.authorityLo, J=rp00041en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1097/00007632-200003150-00017en_US
dc.identifier.pmid10752110-
dc.identifier.scopuseid_2-s2.0-0034654213en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0034654213&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume25en_US
dc.identifier.issue6en_US
dc.identifier.spage745en_US
dc.identifier.epage748en_US
dc.identifier.isiWOS:000086058400017-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridYung, BCK=7006495151en_US
dc.identifier.scopusauthoridCheng, JCK=37043558800en_US
dc.identifier.scopusauthoridChan, TTF=36795665100en_US
dc.identifier.scopusauthoridLoke, TKL=6701863756en_US
dc.identifier.scopusauthoridLo, J=7201650902en_US
dc.identifier.scopusauthoridLau, PY=35829427900en_US

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