Timing of surgical interventions for upper cervical epidural abscess: a case report and review of the literature

  • Takaomi KobayashiEmail author
  • Hiroshi Ureshino
  • Kensuke Hotta
  • Ko Ikuta
Letter to the Editor • SPINE - INFECTION

We report a rare case of upper cervical (occiput to C2) epidural abscess (UCEA) unsuccessfully treated with antibiotics. An 88-year-old man presented with a 5-day history of fever, neck pain, and a limb weakness. Laboratory tests revealed a white blood cell count of 26,600/mm3 and a C-reactive protein level of 295 mg/L. T2-weighted magnetic resonance imaging of the cervical spine demonstrated a high-signal intensity lesion surrounding the dens. Blood cultures revealed the presence of methicillin-sensitive Staphylococcus aureus; thus, antibiotics were initiated. However, he suddenly developed limb paralysis and respiratory failure, leading to rapid decoration in his condition; subsequently, he died 35 h after admission. Autopsy findings revealed an UCEA that resulted in fatal spinal cord compression.

Subsequently, we reviewed the literature pertaining to surgical interventions and antibiotics for the treatment of UCEA to investigate the timing of surgical interventions, which can...


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Conflict of interest

The authors declare that they have no competing interests.


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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Orthopedic SurgeryKaratsu Red Cross HospitalKaratsuJapan
  2. 2.Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of MedicineSaga UniversitySagaJapan

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