Abstract
A spinal epidural abscess (SEA) is a rare condition that has a devastating impact on the patient’s health. It is difficult to diagnose and can present with a myriad of symptoms with or without the involvement of a neurological deficit. The conditions that lead to immunocompromised status, such as malnutrition, diabetes, intravenous drug abuse, previous surgical intervention, and human immunodeficiency virus (HIV) infection/acquired immune deficiency syndrome (AIDS) can predispose a patient to SEA. The most common organisms isolated from the affected patient include Staphylococcus aureus and Streptococcus species while an abscess in some cases can be caused by tuberculosis and fungal and parasitic infections. Among the other causative organisms is Burkholderia pseudomallei (B. pseudomallei), also known as Pseudomonas pseudomallei, which is a Gram-negative, bipolar, aerobic, motile, and rod-shaped bacterium. It is a soil-dwelling bacterium, which is endemic in tropical and subtropical regions worldwide, particularly in Thailand and northern Australia, and causes melioidosis. To our knowledge, SEA caused by B. pseudomallei from the Indian subcontinent has not been reported in the literature. In this case report, we present the case of a patient with SEA caused by B. pseudomallei.
Highlights
Spinal epidural abscess (SEA) is a rare but potentially devastating condition, which may lead to a permanent neurological deficit and even death if not managed promptly
We present the case of a patient with spinal epidural abscess (SEA) caused by B. pseudomallei
It is caused by an infection of the soft tissues and bone of the spinal column characterized by the accumulation of pus in the epidural space, which leads to spinal cord compression
Summary
Spinal epidural abscess (SEA) is a rare but potentially devastating condition, which may lead to a permanent neurological deficit and even death if not managed promptly. SEA with paraplegia is an emergency condition that requires the urgent decompression of the spinal cord, as it may lead to a permanent neurological deficit if left untreated. The patient initially presented with low back pain mimicking sacroiliitis, but later, the condition was diagnosed as SEA and managed with midline posterior decompression and evacuation of pus along with antibiotics. Blood culture report showed the presence of B. pseudomallei, which was sensitive to imipenem and aminoglycosides, and so the patient was put on antibiotics. At the three-month follow-up, the patient had recovered completely
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