Spinal Subdural Staphylococcus Aureus Abscess: case report and review of the literature

We present a patient 75 years old who had a history of diabetes and suffered acute low back pain in the region of the lumbar spine for the last 4 days before his admission to the hospital. He also experienced lower leg weakness, fever and neck stiffness. After having a brain CT scan and a lumbar puncture the patient hospitalized with the diagnosis of meningitis. Five days after his admission the diagnosis of subdural abscess secured with contrast – enhanced MRI but meanwhile the condition of the patient impaired with respiratory failure and quadriplegia and he was admitted to the ICU. A laminectomy was performed eight days after his admission into the hospital but unfortunately the patient died.Early diagnosis and treatment are very important for the good outcome in patients with subdural abscess. Although morbidity and mortality are very high, surgical and antibiotic treatment should be established as soon as possible after the diagnosis has secured.Spinal subdural abscess (SSA) is a very rare entity. Its exact incidence is unknown and to date only 64 cases have been reported in the literature [1]. Staphylococcus aureus (staph aureus) is the most common bacterial source [1-3] and thoraco – lumbar spine is the most affected region [1,2,4]. MRI is the diagnostic modality of choice. The first subdural empyema was reported in 1927 [5]. Bacterial abscesses involving spinal canal are associated with high morbidity and mortality, while early diagnosis and emergent treatment are vital to prevent the formation and progression of neurologic deficits and death. In this report, we present a patient with SSA in the thoracic and lumbar region.A 75-year-old man with a past medical history of diabetes mellitus was admitted to the Emergency Department of our University Hospital. He had a history of acute low back pain in the region of the lumbar spine in the last 4 days before his admission to the hospital. Two days before his admission he experienced lower leg weakness and fever (