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J Korean Soc Spine Surg. 2017 Dec;24(4):236-240. Korean. Case Report. https://doi.org/10.4184/jkss.2017.24.4.236
Kim MW , Lee KY .
Department of Orthopedic Surgery, College of Medicine, Dong-A University, Busan, Korea. drkimminwoo@naver.com
Abstract

Study Design

Case report.

Objectives

To report an unusual case of an abscess of the cervical spine caused byKlebsiella peumoniae accompanied by an acute compressive flexion injury.

Summary of Literature Review

Spondylitis caused by Klebsiella peumoniae is very rare, and an unrecognized epidural abscess complicated with spinal cord compression can lead to severe neurologic deficits.

Materials and Methods

A 66-year-old male patient diagnosed with a liver abscess caused by Klebsiella peumoniae was referred from the internal medicine department to our department due to abrupt posterior neck pain and limitation of motion after a fall from the bed. He showed persistent fever and progressive dysphagia. We diagnosed the condition as a massive cervical abscess caused by Klebsiella peumoniae accompanied by an acute compressive flexion injury. We performed drainage of the massive abscess, anterior fusion to treat the loss of the intervertebral discs at the C3/4 level, and corpectomy for a compression fracture of the C6 vertebral body using a cage and plate via an anterior approach. Subsequently, we performed posterior laminectomy with drainage at the C3-6 level and posterior instrumentation of C2-7 via a posterior approach.

Results

Starting on the second postoperative day, the patient showed a decreased fever and gradual restoration of muscle strength and function in the upper extremities and hands.

Conclusions

Klebsiella peumoniae may cause spinal infection as an opportunistic infection in patients with impaired immune function, and cervical infections in particular require aggressive early treatment because serious neurological symptoms may occur, even in cases of minor trauma.

Copyright © 2019. Korean Association of Medical Journal Editors.