Epidural abscess secondary prevention: Difference between revisions
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==Overview== | ==Overview== | ||
An epidural abscess is a rare suppurative infection of the [[central nervous system]], a collection of [[pus]] localised in the [[epidural space]] lying outside the [[dura mater]], which accounts for less than 2% of focal [[CNS]] infections. <ref>{{Cite book | last1 = Longo | first1 = Dan L. (Dan Louis) | title = Harrison's principles of internal medici | date = 2012 | publisher = McGraw-Hill | location = New York | isbn = 978-0-07-174889-6 | pages = }}</ref> It may occur in two different places: [[intracranial space|intracranially]] or in the [[spinal canal]]. Due to the fact that the initial symptoms and clinical characteristics are not always identical and are similar to other diseases, along with the fact that they are both rare conditions, the final diagnosis might be delayed in time. This late diagnosis comes at great cost to the patient, since it is usually accompanied by a bad prognosis and severe complications, with a potential fatal outcome. According to the location of the collection, the [[abscess]] may have different origins, different organisms involved, symptoms, evolutions, complications and therapeutical techniques. <ref name="DannerHartman1987">{{cite journal|last1=Danner|first1=R. L.|last2=Hartman|first2=B. J.|title=Update of Spinal Epidural Abscess: 35 Cases and Review of the Literature|journal=Clinical Infectious Diseases|volume=9|issue=2|year=1987|pages=265–274|issn=1058-4838|doi=10.1093/clinids/9.2.265}}</ref> The treatment of [[epidural abscess]] focuses in two main aspects: reduction of the [[inflammatory]] mass | An epidural abscess is a rare [[suppurative]] [[infection]] of the [[central nervous system]], a collection of [[pus]] localised in the [[epidural space]], lying outside the [[dura mater]], which accounts for less than 2% of focal [[CNS]] infections. <ref>{{Cite book | last1 = Longo | first1 = Dan L. (Dan Louis) | title = Harrison's principles of internal medici | date = 2012 | publisher = McGraw-Hill | location = New York | isbn = 978-0-07-174889-6 | pages = }}</ref> It may occur in two different places: [[intracranial space|intracranially]] or in the [[spinal canal]]. Due to the fact that the initial symptoms and clinical characteristics are not always identical and are similar to other diseases, along with the fact that they are both rare conditions, the final [[diagnosis]] might be delayed in time. This late [[diagnosis]] comes at great cost to the patient, since it is usually accompanied by a bad [[prognosis]] and severe [[complications]], with a potential fatal outcome. According to the location of the collection, the [[abscess]] may have different origins, different organisms involved, symptoms, evolutions, complications and therapeutical techniques. <ref name="DannerHartman1987">{{cite journal|last1=Danner|first1=R. L.|last2=Hartman|first2=B. J.|title=Update of Spinal Epidural Abscess: 35 Cases and Review of the Literature|journal=Clinical Infectious Diseases|volume=9|issue=2|year=1987|pages=265–274|issn=1058-4838|doi=10.1093/clinids/9.2.265}}</ref> The treatment of [[epidural abscess]] focuses in two main aspects: reduction of the [[inflammatory]] mass and eradication of the responsible organism. These goals can be reached through a combination of [[medical]] and [[surgical]] approaches. An early [[surgical]] decompression and drainage, along with an aggressive [[antibiotic]] treatment is the ideal procedure to increase the chances of a better [[outcome]]. | ||
==Secondary Prevention== | ==Secondary Prevention== | ||
Revision as of 23:45, 30 March 2014
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
An epidural abscess is a rare suppurative infection of the central nervous system, a collection of pus localised in the epidural space, lying outside the dura mater, which accounts for less than 2% of focal CNS infections. [1] It may occur in two different places: intracranially or in the spinal canal. Due to the fact that the initial symptoms and clinical characteristics are not always identical and are similar to other diseases, along with the fact that they are both rare conditions, the final diagnosis might be delayed in time. This late diagnosis comes at great cost to the patient, since it is usually accompanied by a bad prognosis and severe complications, with a potential fatal outcome. According to the location of the collection, the abscess may have different origins, different organisms involved, symptoms, evolutions, complications and therapeutical techniques. [2] The treatment of epidural abscess focuses in two main aspects: reduction of the inflammatory mass and eradication of the responsible organism. These goals can be reached through a combination of medical and surgical approaches. An early surgical decompression and drainage, along with an aggressive antibiotic treatment is the ideal procedure to increase the chances of a better outcome.
Secondary Prevention
Attending to the concept of secondary prevention, in which efforts are directed at reducing disease progression, avoiding emergence of symptoms, in epidural abscess, secondary prevention is related to the early diagnosis of the disease. It is of extreme importance that cases of sinusitis, head and spinal trauma, neurosurgery, local and proximal infectious processes are diagnosed early and treated promptly, in order to prevent the extension of the disease to the epidural space.
References
- ↑ Longo, Dan L. (Dan Louis) (2012). Harrison's principles of internal medici. New York: McGraw-Hill. ISBN 978-0-07-174889-6.
- ↑ Danner, R. L.; Hartman, B. J. (1987). "Update of Spinal Epidural Abscess: 35 Cases and Review of the Literature". Clinical Infectious Diseases. 9 (2): 265–274. doi:10.1093/clinids/9.2.265. ISSN 1058-4838.