J Korean Orthop Assoc.  2017 Aug;52(4):359-363. 10.4055/jkoa.2017.52.4.359.

Serratia marcescens Spinal Epidural Abscess Following Caudal Epidural Injection

• Yu CE
• Choi BY
• Kim KT
• Park YC

• KMID: 2387796
• DOI: http://doi.org/10.4055/jkoa.2017.52.4.359

Abstract

Spinal infection due to Serratia marcescens is very rare. A 78-year-old male patient withoutany risk factor was admitted to our hospital with chief complaints of severe back pain, fever, weakness in both legs, and bowel dysfunction, following caudal epidural injection. Magnetic resonance imaging revealed spondylodiscitis with epidural abscess. Surgical decompression was performed and the epidural abscess was removed. The cultures isolated S. marcescens, which can cause nosocomial infection in immunocompromised patient. However, to the best of our knowledge, we report the first case of S. marcescens spinal epidural abscess following epidural injection, with literature review.

Keyword

spinal epidural abscess; epidural injection; Serratia marcescens

MeSH Terms

Aged
Back Pain
Cross Infection
Decompression, Surgical
Discitis
Epidural Abscess*
Fever
Humans
Immunocompromised Host
Injections, Epidural*
Leg
Magnetic Resonance Imaging
Male
Risk Factors
Serratia marcescens*
Serratia*

Figure

• 

  Figure 1 T2-weighted magnetic resonance sagittal image (A) and axial images (B, C) showing abscess located in the posterior epidural space at the L2–3 level and anterior epidural space at the L4 level.

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  Figure 2 T1-weighted gadoliniumenhanced axial images at the L2–3 (A) and L4–5 intervertebral disc level (B) show an abscess with rim-enhancement compressing the dural sac.

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  Figure 3 Red pigmentation of Serratia marcescens discharged from wound blood-red (A) compared with other usual open wounds (B).

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