Spinal subdural abscess: a rare complication of decubitus ulcer

• Published in: Clinical medicine & research Vol. 12; no. 1-2; pp. 68 - 72
• Main Authors: Usoltseva, Natalia, Medina-Flores, Rafael, Rehman, Ateeq, Samji, Swetha, D'Costa, Matthew
• Format: Journal Article
• Language: English
• Published: United States Marshfield Clinic 01.09.2014
• Subjects: Abscess - etiology; Case Reports; Empyema, Subdural - etiology; Humans; Male; Middle Aged; Myelitis - etiology; Paraplegia - complications; Pressure Ulcer - complications; Spinal Cord Injuries - complications; Spinal cord injury/complications; Abscess/complications; Empyema; subdural/diagnosis/microbiology; Subdural abscess; Bacteroides infections/complications
• ISSN: 1539-4182; 1554-6179
• DOI: 10.3121/cmr.2013.1174

Spinal subdural abscess (SSA) is an uncommon entity. The exact incidence is unknown, with very few cases reported in the literature. This condition may result in spinal cord compression, thus constituting a medical and neurosurgical emergency. The pathogenesis of SSA is not well-described, and the available knowledge is based on case observations only. There is only one case report that describes direct seeding from decubitus ulcers as a possible mechanism for development of SSA. We report a case of subacute onset of quadriplegia in a male patient, age 55 years, due to spinal cord compression from SSA and superimposed spinal subdural hematoma. The direct seeding from decubitus ulcers is thought to be the cause of infection in our patient. We present this case of SSA to elucidate and review the predisposing factors, pathogenesis, clinical presentation, diagnostic modalities, and treatment regarding management of this rare disorder.