Epidural abscess related to Streptococcus mitis in a 57-year-old immunocompetent patient

• Published in: BMJ case reports Vol. 14; no. 4; p. e239295
• Main Authors: Prod'homme, Marc, Grasset, Didier, Chalaron, Marc, Boscherini, Duccio
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 09-04-2021; BMJ Publishing Group
• Subjects: Abscesses; Antibiotics; Case Report; Case reports; Endocarditis; Epidural; Epidural Abscess - diagnostic imaging; Epidural Abscess - drug therapy; Humans; Immunocompetence; Low Back Pain; Lumbar Vertebrae; Male; Middle Aged; Pain; Pathogens; Patients; Signs; Streptococcal Infections - diagnosis; Streptococcal Infections - drug therapy; Streptococcus infections; Streptococcus mitis; Substance abuse treatment; Surgery; Teeth; Wound healing; infections; orthopaedics
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr-2020-239295

A 57-year-old immunocompetent male patient presented himself to our emergency department with lumbar pain for 10 days, after a lumbar torsion. He was neurologically intact, but showed signs of systemic inflammatory syndrome. A lumbar MRI found a spinal epidural abscess from L3-L4 to L5-S1 levels. The patient was operated early before occurrence of neurological deficit. The abscess cultures found a Streptococcus mitis infection. The patient made a good recovery after surgical decompression, washout with samples taken for cultures and targeted antibiotic therapy for 6 weeks.