Serratia marcescens Spinal Epidural Abscess Following Caudal Epidural Injection

Chang-Eon Yu; Byeong-Yeol Choi; Kyung-Tae Kim; Young-Chul Park

doi:10.4055/jkoa.2017.52.4.359

Journal List > J Korean Orthop Assoc > v.52(4) > 1013539

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Yu, Choi, Kim, and Park: Serratia marcescens Spinal Epidural Abscess Following Caudal Epidural Injection

Original Article

J Korean Orthop Assoc 2017;52(4):359-363.

Published online: 1 December 2017

DOI: https://doi.org/10.4055/jkoa.2017.52.4.359

Serratia marcescens Spinal Epidural Abscess Following Caudal Epidural Injection

Chang-Eon Yu, M.D., Byeong-Yeol Choi, M.D., Kyung-Tae Kim, M.D., Young-Chul Park, M.D.

Department of Orthopedic Surgery, Presbyterian Medical Center, Jeonju, Korea

Correspondence to: Byeong-Yeol Choi, M.D. Department of Orthopedic Surgery, Presbyterian Medical Center, 365, Seowon-ro, Wansan-gu, Jeonju 54987, Korea TEL: +82-63-230-8744 FAX: +82-63-230-1439 E-mail: docby@hanmail.net

Received 6 December 2016 Revised 28 December 2016 Accepted 10 January 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

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Keywords: spinal epidural abscess, epidural injection, Serratia marcescens

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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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