Spinal epidural abscess caused by Streptococcus agalactiae in an immunocompetent patient

Abstract

BackgroundStreptococcus agalactiae is an uncommon microorganism that causes spinal epidural abscess (SEA) and usually affects individuals with a predisposing condition or potential source of infection. Case descriptionWe present the case of an immunocompetent 53-year-old patient with an unremarkable past medical history who developed progressive low extremity weakness, bowel and bladder dysfunction and genital sensory impairment. A neurological exam on admission revealed flaccid proximal paraparesis, T10 sensory level, atonic anal sphincter and normal myotatic reflexes. Urgent neuroimaging showed a large thoracic epidural spinal abscess. Laminectomy and abscess drainage were immediately performed and systemic antibiotic treatment was initiated. Abscess cultures revealed S. agalactiae. After an exhaustive workup no predisposing factors or local or systemic source for the infection were found after a one-year follow-up and rehabilitation the patient achieved a satisfactory neurological outcome. ConclusionsWe report a singular case of spinal epidural abscess caused by S. agalactiae in a healthy patient with no predisposing factors. This case also highlights the importance of an early diagnosis and treatment to obtain a better neurological outcome.