Jpn. J. Infect. Dis., 58, 177-179, 2005
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Short Communication
Spinal Epidural Abscess Caused by Group B
Streptococcus in a Diabetic Woman Presenting with Febrile
Low Back Pain
Shyi-Yu Chung, Chia-Hung Chen and Wen-Liang Yu1,2*
Division of Nephrology, Department of Internal Medicine, China
Medical University Hospital, Taichung, 1Department
of Critical Care Medicine, Chi-Mei Medical Center, Tainan and
2Department of Medicine, Taipei
Medical University, Taipei, Taiwan
(Received January 4, 2005. Accepted March 4, 2005)
*Corresponding author: Mailing address: Department of Critical
Care Medicine, Chi-Mei Medical Center, 901 Chung-Hwa Road, Yungkang
City, Taiwan. Tel: 886-6-2812811 ext. 52605, Fax: +886-6-2833351,
E-mail: Yuleon_md@yahoo.com.tw
SUMMARY: Because spinal epidural abscess is usually ignored
in the preliminary differential diagnosis of low back pain, appropriate
treatment may be delayed. Adult spinal epidural abscess is sparsely
caused by the pathogen known as group B Streptococcus.
In this paper, we report the case of a diabetic woman with lumbar
epidural abscess and vertebral osteomyelitis caused by group B
Streptococcus. Owing to the main manifestations of fever,
pyuria and low back pain, which originally led us to suspect acute
pyelonephritis, empirical antibiotics were applied. When the symptoms
and signs persisted, other focal infections were considered. Magnetic
resonance imaging led to the correct diagnosis. Group B Streptococcus
was isolated from the blood but not from the abscess itself, probably
due to the prior antibiotic treatment. The patient recovered well
after surgical debridement followed by prolonged intravenous penicillin
therapy. Therefore, despite the potential for fatality, our results
suggest that epidural abscess can be successfully treated with
surgery and antibiotic therapy provided that it is detected early
enough.
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