Scholarlink

Background <p>Spinal epidural abscesses (SEA) are rare but severe infections with a risk of neurological sequelae. Data focusing specifically on <i>Staphylococcus aureus</i> SEA remain scarce, despite this pathogen being the leading cause. The prognosis of primary versus secondary SEA, and the role of medical versus surgical management remain debated. We aimed to describe the clinical, microbiological and therapeutic features of <i>S. aureus</i> SEA and to identify potential prognostic factors.</p> Methods <p>We conducted a retrospective review of <i>S. aureus</i> SEA managed in two French tertiary centers. Comparative analyses were performed between primary and secondary SEA, and between patients with favorable versus poor neurological outcomes.</p> Results <p>Between May 2007 and June 2025, 65 patients were included, representing the largest cohort focusing exclusively on <i>S. aureus</i> SEA. Median age was 61 years (IQR 51–71), with a male predominance (63%). Intravenous drug use was frequent (16%). Most cases were secondary to spondylodiscitis (86%), while primary SEA accounted for 14% and were associated with more severe initial neurological deficits. A cutaneous portal of entry was associated with better outcomes, whereas implant-related infections and unidentified sources predicted poorer prognosis. Methicillin-resistant <i>S. aureus</i> showed a non-significant trend toward worse outcomes. Surgery was performed in 40% of patients, mainly in those with deficits. Among medically managed patients, 78% were alive without neurological sequelae at three months.</p> Conclusion <p>This study highlights clinical differences between primary and secondary SEA and the prognostic value of portal-of-entry identification. Conservative management appears effective in selected patients without neurological deficits, provided careful multidisciplinary monitoring is ensured.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Isolated Staphylococcus aureus spinal epidural abscesses: severe initial neurological deficits do not predict worse outcomes compared with spondylodiscitis-associated cases

  • 期刊论文

  • 发表日期：

    2026年4月27日

查看全文
  • Guillaume Cosson,
  • Wassim Allaham,
  • Marc-Antoine Rousseau,
  • Matthieu Faillot,
  • Agnès Lefort,
  • Aurélien Dinh,
  • Virginie Zarrouk

摘要

Background

Spinal epidural abscesses (SEA) are rare but severe infections with a risk of neurological sequelae. Data focusing specifically on Staphylococcus aureus SEA remain scarce, despite this pathogen being the leading cause. The prognosis of primary versus secondary SEA, and the role of medical versus surgical management remain debated. We aimed to describe the clinical, microbiological and therapeutic features of S. aureus SEA and to identify potential prognostic factors.

Methods

We conducted a retrospective review of S. aureus SEA managed in two French tertiary centers. Comparative analyses were performed between primary and secondary SEA, and between patients with favorable versus poor neurological outcomes.

Results

Between May 2007 and June 2025, 65 patients were included, representing the largest cohort focusing exclusively on S. aureus SEA. Median age was 61 years (IQR 51–71), with a male predominance (63%). Intravenous drug use was frequent (16%). Most cases were secondary to spondylodiscitis (86%), while primary SEA accounted for 14% and were associated with more severe initial neurological deficits. A cutaneous portal of entry was associated with better outcomes, whereas implant-related infections and unidentified sources predicted poorer prognosis. Methicillin-resistant S. aureus showed a non-significant trend toward worse outcomes. Surgery was performed in 40% of patients, mainly in those with deficits. Among medically managed patients, 78% were alive without neurological sequelae at three months.

Conclusion

This study highlights clinical differences between primary and secondary SEA and the prognostic value of portal-of-entry identification. Conservative management appears effective in selected patients without neurological deficits, provided careful multidisciplinary monitoring is ensured.