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Case Reports
. 2021 Mar 4;13(3):e13703.
doi: 10.7759/cureus.13703.

Spontaneous Posterior Subdural Pyogenic Escherichia coli Abscess Secondary to Lumbar Spondylodiscitis

Joseph J Gleeson  1 , Andrew J Berg  1 , Peter R Loughenbury  1 , Senthil K Selvanathan  1 , Andraay Leung  1
Affiliations
Case Reports

Spontaneous Posterior Subdural Pyogenic Escherichia coli Abscess Secondary to Lumbar Spondylodiscitis

Joseph J Gleeson et al. Cureus. .

Abstract

Pyogenic subdural spinal collections are rare but an important pathology to recognise and manage appropriately. We report the case of a 56-year-old female who developed a posterior subdural spinal collection associated with local discitis. There was no direct communication between the infected disc and subdural space, and the collection was located posteriorly within the subdural space which makes this case all the more unusual. We discuss the need for spinal subdural collections to be considered as a differential in patients with back pain and lower limb neurology (especially when there is a known spinal infective focus), the importance of careful interpretation of imaging, and the pathophysiological mechanisms and organisms known to cause spinal subdural collections.

Keywords: e. coli; gram negative bacteremia; laminectomy; spinal abscess surgery; spinal decompression; spinal mri; spinal subdural abscess; spondylodiscitis.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. T2 TSE Sagittal and Axial MRI showing fluid in the L4/5 disc space (red arrow) and vertebral body oedema consistent with discitis and osteomyelitis along with an anterior epidural collection (blue arrows).
TSE - Turbo Spin Echo; MRI - Magnetic Resonance Imaging
Figure 2
Figure 2. T2 TSE Sagittal and Axial MRI showing worsening of the epidural collection with proximal extension (red arrows).
TSE - Turbo Spin Echo; MRI - Magnetic Resonance Imaging
Figure 3
Figure 3. T1 TSE with Gadolinium and Axial T2 TSE show subdural collection posteriorly at L1 – L3 levels. Normal epidural fat is visible posteriorly with plane indicating dura (red arrow).
TSE - Turbo Spin Echo
Figure 4
Figure 4. Post-operative T2 TSE Sagittal and Axial MRI showing posterior fluid collections in keeping with recent surgery (blue arrows) and reduction in subdural collection (red arrows).
TSE - Turbo Spin Echo; MRI - Magnetic Resonance Imaging
See this image and copyright information in PMC

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