Correct!
5. All of the above
Clinical presentation of paraspinous abscess can be quite variable (2). One half of cases are estimated to be misdiagnosed or have a delayed diagnosis. If untreated, an expanding suppurative infection in the spinal epidural space impinges on the spinal cord, producing sensory symptoms and signs, motor dysfunction, and, ultimately, paralysis and death.
Most recommend a combination of antistaphylococcal antibiotics and surgical decompression. Antibiotic treatment with CT-guided aspiration of the epidural space is increasingly used in patients without neurologic deficits but because of the rarity of the disorder, no randomized trial results are available to guide the clinician.
On day 2 our patient’s blood cultures were reported positive for Gram + cocci in clusters and he underwent a C2-C7 laminectomy. By day 3 his strength had recovered and on day 5 the organism in the blood cultures was identified as methicillin-resistance Staphylococcus aureus (MRSA). He was treated with 4 weeks of antibiotic therapy and made a full and uneventful recovery. The source of the infection was never identified.
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