Neisseria gonorrhoeae paravertebral abscess: Case report
Journal
Journal of Neurosurgery: Spine
Journal Volume
17
Journal Issue
1
Pages
93-97
Date Issued
2012
Author(s)
Abstract
The authors present the case of an isolated gonococcal paravertebral abscess with an epidural component in a 42-year-old man. A primary epidural abscess of the spine is a rare condition and is most commonly caused by Staphylococcus aureus. In this report, the authors present their therapeutic decisions and review the relevant literature on disseminated gonococcal infection in a patient presenting with an epidural abscess. A 42-year-old Indonesian man was admitted with symptoms of neck and upper back pain and bilateral lower-limb weakness. Clinical examination was unremarkable apart from tenderness over the lower cervical spine. Postgadolinium T1-weighted MRI of the cervical and thoracic spine demonstrated an enhancing lesion in the right paraspinal and epidural soft tissue at C-6 to T1-2, in keeping with a spinal epidural abscess. The patient underwent laminectomy of C-7 and T-1 with abscess drainage. Tissue cultures subsequently grew Neisseria gonorrhoeae that was resistant to quinolones by genotyping. Upon further questioning, the patient admitted to unprotected sexual intercourse with commercial sex workers. Further investigations showed that he was negative for other sexually transmitted infections. Postoperatively, he received a course of beta-lactam antibiotics with good recovery. Clinicians should be aware of this unusual disseminated gonococcal infection manifested in any patient with the relevant risk factors.
SDGs
Other Subjects
azithromycin; beta lactam antibiotic; C reactive protein; ceftriaxone; ciprofloxacin; cloxacillin; doxycycline; gadolinium; glucose; glycosylated hemoglobin; insulin; quinolone; restriction endonuclease; abscess drainage; adult; article; backache; case report; cervical spine; chlamydial urethritis; clinical examination; diabetes mellitus; drug megadose; epidural abscess; erythrocyte sedimentation rate; gene mutation; genotype; glucose blood level; gonorrhea; hemoglobin blood level; human; human tissue; Indonesia; laminectomy; leukocyte count; limb weakness; male; neck pain; Neisseria gonorrhoeae; nonspecific urethritis; nuclear magnetic resonance imaging; peripherally inserted central venous catheter; prostitution; pus; radiological parameters; sexual intercourse; sexually transmitted disease; single drug dose; spinal cord decompression; Staphylococcus infection; tissue culture; Adult; beta-Lactams; Cervical Vertebrae; Diagnosis, Differential; Drainage; Epidural Abscess; Gonorrhea; Humans; Laminectomy; Magnetic Resonance Imaging; Male; Microbial Sensitivity Tests; Neurologic Examination; Postoperative Care; Thoracic Vertebrae
Type
journal article