Abscesso espinhal epidural por disseminação hematogênica: relato de caso

Resumo

Abscesso espinhal epidural é uma doença rara de diagnóstico difícil, sendo que o principal fator prognóstico é o diagnóstico breve. A maioria dos pacientes, porém, tem o diagnóstico tardio, quando já existem sintomas neurológicos que podem permanecer após o tratamento. Na maioria dos casos, os sintomas iniciais são dor nas costas, febre e paralisia. O tratamento é feito à base de antibioticoterapia empírica e, caso não haja contraindicação, descompressão e drenagem cirúrgica. Relata-se o caso de uma paciente que sofreu paralisia súbita nos membros inferiores. Inicialmente, havia suspeita de mielite transversa, mas a evolução do caso permitiu o diagnóstico de abscesso espinhal epidural em T6, T7 e T8, causada por disseminação hematogênica de Staphylococcus aureus.

Abstract

Spinal epidural abscess is a rare and difficult disease to diagnose, and the main prognostic factor is the early diagnosis. Most patients, however, have their diagnosis delayed to when they already have neurological symptoms that may remain after treatment. In most cases, the initial symptoms are back pain, fever and paralysis. Treatment is based on empirical antibiotic therapy and, if there is no contraindication, decompression and surgical drainage. We report the case of a patient who suffered sudden paralysis of the inferior members. Initially suspected as transverse myelitis, the case evolved, allowing the diagnosis of spinal epidural abscess in T6, T7 and T8, caused by hematogenous spread of Staphylococcus aureus.

Palavras-Chave

abscesso espinhal epidural - paralisia - disseminação hematogênica

Keywords

spinal epidural abscess - paralysis - hematogenous spread

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