Peculiarities of spinal epidural abscess in COVID-19 patients: a literature review

<p>During the SARS-CoV-2 pandemic, some authors described an increased incidence of primary Spinal Epidural Abscess (SEA) in COVID-19 patients with clinical and radiological peculiarities. Early recognition of this disease remains challenging, resulting in delayed diagnosis and significant mor...

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Asıl Yazarlar: Pietro Domenico Giorgi (Yazar), Giuseppe Rosario Schirò (Yazar), Davide Colistra (Yazar), Simona Legrenzi (Yazar), Jacopo Falco (Yazar), Maria Ludovica Pallotta (Yazar), Giuseppe Talamonti (Yazar)
Materyal Türü: Kitap
Baskı/Yayın Bilgisi: Journal of Neurology, Neurological Science and Disorders - Peertechz Publications, 2023-03-20.
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Özet:<p>During the SARS-CoV-2 pandemic, some authors described an increased incidence of primary Spinal Epidural Abscess (SEA) in COVID-19 patients with clinical and radiological peculiarities. Early recognition of this disease remains challenging, resulting in delayed diagnosis and significant morbidity and mortality. The authors performed a systematic review of the literature in PubMed, Cochrane, and Scopus about the traditional form of SEA comparing the main features related to COVID-19 SEA. The search was performed from 1990 to 2020. Magnetic Resonance Imaging with contrast is mandatory to recognize this kind of lesion in order to obtain a differential diagnosis. COVID-19 SEAs are generally active abscesses, with a large cystic component. Gadolinium-enhanced MR images can aid in the definition of the age and consistency of the abscess. A rim of tissue that enhances after the injection of gadolinium represents granulation tissue; liquid pus is associated with an area of low signal intensity on T1-weighted images.</p><p>This new type of SEA in COVID-19 patients showed several differences also in clinical features. No evidence of an external infective source was found (spondylodiscitis, surgery, or percutaneous treatment). None of the patients was a drug abuser and MSSA was the only responsible pathogen. The cervicothoracic spine was the most involved site. Further studies are needed to confirm these preliminary findings.</p>
DOI:10.17352/jnnsd.000050