Article
Epidural empyema and severe diabetes: recovering after conservative treatment: a case report
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Published: | May 4, 2005 |
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We report a case of rapidly developing paraparesia in a feverish context. The anamnesis reveals a non treated diabetes over ten years. The initial clinical statement showed a severe paraparesia (2/5) without sensitive level, a diabetes mellitus (2.5g/l) without acidosis nor ketone bodies, a severe infection syndrome. Blood culture proved a septicemia of Streptococcus agalactae. The MRI showed a posterior epidural empyema extended from T2 to L2 with several muscular abscesses.
Conservative treatment was decided. The antibiotherapy instored was amoxicilline and gentamicine, combined with continuous insulinotherapy. Paraplegia regressed within ten days. Control MRI confirmed the regression of the empyema.
The literature found a similar case with good outcome after medical treatment. This points out the interest of instoring first a medical treatment in those patients despite the severity of neurological statement or radiological signs.