Search

E. Epidural abscess

1.
증가추세 (d/t 면역억제, IV drug use, spinal procedure), S.aureus (m/c, 70%)
2.
임상양상 (1) Triad : Back pain(m/c, 70~90%), Fever, 신경학적 증상 (2) Stage ① Stage.1 : Back pain, fever, spinal tenderness ② Stage.2 : 방사통, hyperreflexia ③ Stage.3 : 뇨실금, motor weakness ④ Stage.4 : Paralysis (3) Full NEx. 필요, Rectal tone 감소 (60~80% sensitivity)
3.
진단 (1) LP는 abscess 의심 시 하지 않음 → meningitis의 위험 증가 (2) MRI with gadolinium (gold standard), CT with myelography
4.
치료 (1) 수술 고려 (2) Antibiotics : Vancomycin + Cefrazidime or Cefepime (+ gentamycin in post-NS op.)