Epiduritis purulent

Epiduritis purulent

Purulent epiduritis is a rapidly developing inflammation of the epidural tissue of the spinal canal with the formation of purulent exudate, which occurs secondary to the presence of foci of infection in the body. Often accompanied by spinal meningitis. Etiology – hematogenous spread of infection (most often staphylococcus aureus).

Clinical picture

• • Intoxication syndrome (high fever, general severe condition)
  • Intense radicular pain in the zone of innervation of the corresponding spinal nerves
  • Local pain, aggravated by palpation and percussion
  • Meningeal syndrome (see Bacterial meningitis)
  • Signs of increasing compression of the spinal cord (paralysis or paresis of the limbs, impaired sensitivity below the level of compression and the functions of the pelvic organs).

Research methods

• • Laboratory studies: confirm the presence of inflammation (neutrophilia, shift of the leukocyte formula to the left, increased ESR)
  • Obtaining pus during puncture of the epidural space at the level of the lesion
  • Lumbar puncture reveals some degree of blockade of the subarachnoid space (impaired CSF circulation) and an increase in protein content in the CSF
  • MRI and CT are the most informative. Differential Diagnosis
  • Other diseases that cause compression of the spinal cord (tumors, injuries)
  • transverse myelitis.

Treatment

• • Conservative: broad-spectrum antibiotics
  • With the ineffectiveness of conservative therapy, an operation is indicated – laminectomy (opening the spinal canal by removing the arches of the vertebrae), removal of the abscess, followed by drainage of the epidural space.

Complications

• • Spinal epidural abscess formation
  • The development of purulent meningitis after lumbar puncture with lumbosacral localization of epiduritis (infection in the subarachnoid space).

Synonym. pachymeningitis external

See also Spinal epidural abscess, Bacterial meningitis, Spinal cord tumors, Spinal cord injury ICD

• GOO Bacterial meningitis, not elsewhere classified
• G03 Meningitis due to other and specified causes