RESUMO
Thoracic spinal actinomycosis causing epidural abscess and significant spinal cord compression is very rare. A case is presented of a 56-year-old woman with rapid progressive upper back pain and weakness in both legs without evidence of systemic infection. Magnetic resonance imaging revealed a thoracic epidural enhancing lesion at the T1-T5 level. After decompression by laminectomy, precise diagnosis was accomplished using specific histopathological studies of the surgical specimens. A histopathologic findings showing typical Actinomyces sulfur granules surrounded by acute inflammatory cells. The clinical and radiological findings of spinal actinomycosis closely resemble metastatic tumors and other infectious processes. Delay in diagnosis and treatment can significantly worsen the condition of patient.
Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Actinomyces , Actinomicose , Dor nas Costas , Descompressão , Diagnóstico , Abscesso Epidural , Laminectomia , Perna (Membro) , Imageamento por Ressonância Magnética , Compressão da Medula Espinal , Medula Espinal , EnxofreRESUMO
Actinomycosis with spinal involvement is very rare. We report a case of spinal actinomycosis with symptoms of spnal cord compression. A 55-year-old women had quadriparesis without evidence of systemic infection. In MRI findings, perivertebral granulomaous mass was compressing the sipinal cord at the level of first thoracic sipine with the signal change of cord and bony destruction. The patient was treated with two-staged opreations, antibiotics and rehabilitation training. She has improved neurologically and also in general condition. Due to rarity of incidence of entity, we reviewed the pertinent literature with discussion of diagnosis, treatment and the prognosis of this disease.