Empiema epidural espinal: clínica, diagnóstico y tratamiento a propósito de tres casos / Spinal epidural empyema: clinical, diagnosis and treatment with regard to three cases

El empiema epidural espinal (EEE) es una infección supurada del sistema nervioso central, predomina en el sexo masculino y en la edad media de la vida. El microorganismo mayormente implicado es Staphylococcus aureus. Alcanza el espacio epidural por contigüidad, inoculación directa o diseminación a distancia. Se manifiesta con fiebre, dolor espinal y déficit neurológico. Se presentan tres casos de EEE y se realizan consideraciones clínicas, microbiológicas y terapéuticas.

Abstract Spinal epidural empyema is a suppurating infection of the central nervous system, more frequent in male patients and during the midlife stage. Staphylococcus aureus is the most commonly found microorganism. It reaches the epidural space extending contiguously, by direct inoculation or distant spread. It manifests with fever, spinal pain and neurological deficit. Three cases of spinal epidural empyema are presented and clinical, microbiological and therapeutic considerations are made.

Resumo O empiema epidural espinal (EEE) é uma infecção supurada do sistema nervoso central, predominante no sexo masculino e na meia idade. O micro-organismo implicado na maioria dos casos é o Staphylococcus aureus. Atinge o espaço epidural por contiguidade, inoculação direta ou disseminação a distancia. Manifesta-se com febre, dor espinal e déficit neurológico. Apresentam-se três casos de EEE e fazem-se considerações clínicas, microbiológicas e terapêuticas.

Sphenoidal Sinusitis with Epidural Empyema Presenting as Trigeminal Neuralgia

Trigeminal neuralgia (TN) is a common condition that produces pain in the orofacial area. However, the exact cause of TN is still unknown. Various etiologies such as tumor, multiple sclerosis and other compressive lesions have been implicated as possible causes. A 35-year-old woman was admitted due to right facial pain which was diagnosed as TN. A brain MRI revealed sphenoidal sinusitis with epidural empyema. We report a case of complicated sinusitis with epidural empyema presenting as TN.