Epidural abscess epidemiology and demographics: Difference between revisions

Jump to navigation Jump to search
No edit summary
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Epidural abscess}}
{{Epidural abscess}}
{{CMG}}; {{AE}} {{JS}}
{{CMG}} {{AE}} {{JS}}; {{AG}}


==Overview==
==Overview==
An epidural abscess is a rare suppurative [[infection]] of the [[central nervous system]], a collection of [[pus]] localised in the [[epidural space]], lying outside the [[dura mater]], which accounts for less than 2% of focal [[CNS]] [[infections]]. <ref>{{Cite book  | last1 = Longo | first1 = Dan L. (Dan Louis) | title = Harrison's principles of internal medici | date = 2012 | publisher = McGraw-Hill | location = New York | isbn = 978-0-07-174889-6 | pages =  }}</ref>. It may occur in two different places: [[intracranial space|intracranially]] or in the [[spinal canal]]. According to the location of the [[infection]], the [[epidemiology]] of each one of the two types of [[abscesses]] will differ. This is due to the nature of the location of the disease, but also due to other factors. In either case, in order to prevent severe [[morbidity]] and fatal outcomes, accurate [[diagnosis]] and prompt [[therapy]] should be applied as early as possible.
An epidural abscess is a rare suppurative [[infection]] of the [[central nervous system]], a collection of [[pus]] localized in the [[epidural space]], lying outside the [[dura mater]], which accounts for less than 2% of focal [[central nervous system]] [[infections]].<ref>{{Cite book  | last1 = Longo | first1 = Dan L. (Dan Louis) | title = Harrison's principles of internal medici | date = 2012 | publisher = McGraw-Hill | location = New York | isbn = 978-0-07-174889-6 | pages =  }}</ref> Spinal epidural abscess is rare, accounting for 2.5 to 3 cases per 10,000 hospital admissions per year.<ref name="pmid10229519">{{cite journal |vauthors=Sampath P, Rigamonti D |title=Spinal epidural abscess: a review of epidemiology, diagnosis, and treatment |journal=J Spinal Disord |volume=12 |issue=2 |pages=89–93 |year=1999 |pmid=10229519 |doi= |url= |accessdate=2015-11-09}}</ref> Estimates of the incidence after central nerve block vary from 1 per 1,000 hospital admissions to 1 per 100,000 hospital admissions.<ref name="pmid16431882">{{cite journal |vauthors=Grewal S, Hocking G, Wildsmith JA |title=Epidural abscesses |journal=Br J Anaesth |volume=96 |issue=3 |pages=292–302 |year=2006 |pmid=16431882 |doi=10.1093/bja/ael006 |url= |accessdate=2015-11-09}}</ref> Prevalence is greatest between the fifth and seventh decades of life.<ref name="pmid3589332">{{cite journal |vauthors=Danner RL, Hartman BJ |title=Update on spinal epidural abscess: 35 cases and review of the literature |journal=Rev. Infect. Dis. |volume=9 |issue=2 |pages=265–74 |year=1987 |pmid=3589332 |doi= |url= |accessdate=2015-11-09}}</ref>


==Epidemiology And Demographics==
==Epidemiology And Demographics==
===Intracranial Epidural Abscess===
===Intracranial Epidural Abscess===
The most rare type of [[epidural abscess]], it accounts for only 1 out of 10 cases of the disease. Despite this fact, it is the 3rd most common common focal intracranial [[infection]], following [[brain abscess]] and [[subdural empyema]]. Before the arrival of [[antibiotics]],  the most common causes of [[epidural abscess]] were [[sinusitis]],  [[otitis]] and [[mastoiditis]]. Today it happens most often following [[neurosurgery|neurosurgical]] procedures and in [[IV drug use|IV drug users]]. The cases not related to [[iatrogenesis]] occur more commonly in adolescent males, since they are more prone to [[sinusitis]] and its complications. This incidence is due to the increase of [[vascularity]] of the [[diploic veins|diploic system]] and development of [[frontal sinus]] between the 7th and 20th year of age, which contributes to the spread of the [[infection]], since the [[sinus]] [[mucosa]] communicates with the marrow spaces of the [[frontal bone]], as well as with the [[veins]] of the [[dura mater]]. <ref name="pmid15043336">{{cite journal| author=Fountas KN, Duwayri Y, Kapsalaki E, Dimopoulos VG, Johnston KW, Peppard SB et al.| title=Epidural intracranial abscess as a complication of frontal sinusitis: case report and review of the literature. | journal=South Med J | year= 2004 | volume= 97 | issue= 3 | pages= 279-82; quiz 283 | pmid=15043336 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15043336  }} </ref> According to a study of ''Gallagher et al'' 15 out of 176 patients with [[sinusitis]], developed some kind of intracranial suppuration as a complication. Of these, 23% developed [[epidural abscess]]. <ref name="pmid9818818">{{cite journal| author=Gallagher RM, Gross CW, Phillips CD| title=Suppurative intracranial complications of sinusitis. | journal=Laryngoscope | year= 1998 | volume= 108 | issue= 11 Pt 1 | pages= 1635-42 | pmid=9818818 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9818818  }} </ref>
Intracranial epidural abscess is the more rare type of epidural abscess, accounting for 1 out of 10 cases of the disease. However, it is the 3rd most common focal intracranial infection, following [[brain abscess]] and [[subdural empyema]]. Today it occurs most often following [[neurosurgery|neurosurgical]] procedures and in[[IV drug use|IV drug users]]. Approximately 2% of patients with [[sinusitis]] developed some kind intracranial epidural abscess as a complication.<ref name="pmid9818818">{{cite journal| author=Gallagher RM, Gross CW, Phillips CD| title=Suppurative intracranial complications of sinusitis. | journal=Laryngoscope | year= 1998 | volume= 108 | issue= 11 Pt 1 | pages= 1635-42 | pmid=9818818 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9818818  }} </ref>


===Spinal Epidural Abscess===
===Spinal Epidural Abscess===
The most common type of [[epidural abscess]]. It may occur in patients of all ages, however is more common in those older than 50 years, with studies showing a male predominance of the disease. <ref name="PilkingtonJackson2003">{{cite journal|last1=Pilkington|first1=S. A.|last2=Jackson|first2=S. A.|last3=Gillett|first3=G. R.|title=Spinal epidural empyema|journal=British Journal of Neurosurgery|volume=17|issue=2|year=2003|pages=196–200|issn=0268-8697|doi=10.1080/0268869031000108990}}</ref><ref name="pmid1359381">{{cite journal| author=Darouiche RO, Hamill RJ, Greenberg SB, Weathers SW, Musher DM| title=Bacterial spinal epidural abscess. Review of 43 cases and literature survey. | journal=Medicine (Baltimore) | year= 1992 | volume= 71 | issue= 6 | pages= 369-85 | pmid=1359381 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1359381  }} </ref> The incidence of this disease has doubled during the past two decades, to 0.2-2 cases per 10,000 hospital admissions. Possible explanations for this rise, despite therapy improvements, include: <ref name="Darouiche2006">{{cite journal|last1=Darouiche|first1=Rabih O.|title=Spinal Epidural Abscess|journal=New England Journal of Medicine|volume=355|issue=19|year=2006|pages=2012–2020|issn=0028-4793|doi=10.1056/NEJMra055111}}</ref><ref name="pmid24340840">{{cite journal| author=Strauss I, Carmi-Oren N, Hassner A, Shapiro M, Giladi M, Lidar Z| title=Spinal epidural abscess: in search of reasons for an increased incidence. | journal=Isr Med Assoc J | year= 2013 | volume= 15 | issue= 9 | pages= 493-6 | pmid=24340840 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24340840  }} </ref>
Spinal epidural abscess is the most common type of [[epidural abscess]]. Prevalence is greatest between the fifth and seventh decades of life with a male predominance of the disease.<ref name="pmid3589332">{{cite journal |vauthors=Danner RL, Hartman BJ |title=Update on spinal epidural abscess: 35 cases and review of the literature |journal=Rev. Infect. Dis. |volume=9 |issue=2 |pages=265–74 |year=1987 |pmid=3589332 |doi= |url= |accessdate=2015-11-09}}</ref><ref name="pmid1359381">{{cite journal| author=Darouiche RO, Hamill RJ, Greenberg SB, Weathers SW, Musher DM| title=Bacterial spinal epidural abscess. Review of 43 cases and literature survey. | journal=Medicine (Baltimore) | year= 1992 | volume= 71 | issue= 6 | pages= 369-85 | pmid=1359381 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1359381  }} </ref> Spinal epidural abscess is rare, accounting for 2.5 to 3 cases per 10,000 hospital admissions per year.<ref name="pmid10229519">{{cite journal |vauthors=Sampath P, Rigamonti D |title=Spinal epidural abscess: a review of epidemiology, diagnosis, and treatment |journal=J Spinal Disord |volume=12 |issue=2 |pages=89–93 |year=1999 |pmid=10229519 |doi= |url= |accessdate=2015-11-09}}</ref>  
*Increased [[sensitivity]] and accuracy of the [[diagnostic]] methods, with the use of [[contrast]] enhanced [[MRI]];
*[[Immunocompromised]] and aged population;
*Increased number of [[neurosurgery|neurosurgical]] and other [[spinal cord|spinal]] invasive procedures for [[anaesthesia]] and [[pain management]];
*Increased [[IV drug use|IV drug users]].
In the case of [[spinal cord|spinal]] [[catheter]] placement, the [[infection]] might occur at several occasions, namely:
*At the time of placement of the [[catheter]];
*Ascending contamination from the [[skin flora]];
*Injections through the [[catheter]] with contaminated syringes;
*From [[bacteria]] causing hematogenous seeding of the [[catheter]] material.
According to a meta-analysis published in 2000, "the mortality rates of [[spinal cord|spinal]] [[epidural abscess]] have not changed significantly over the last 25 years". <ref name="pmid24340840">{{cite journal| author=Strauss I, Carmi-Oren N, Hassner A, Shapiro M, Giladi M, Lidar Z| title=Spinal epidural abscess: in search of reasons for an increased incidence. | journal=Isr Med Assoc J | year= 2013 | volume= 15 | issue= 9 | pages= 493-6 | pmid=24340840 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24340840  }} </ref><ref name="pmid11153548">{{cite journal| author=Reihsaus E, Waldbaur H, Seeling W| title=Spinal epidural abscess: a meta-analysis of 915 patients. | journal=Neurosurg Rev | year= 2000 | volume= 23 | issue= 4 | pages= 175-204; discussion 205 | pmid=11153548 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11153548  }} </ref>


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


[[Category:Wikinfect]]
[[Category:Infectious disease]]
[[Category:Infectious disease]]
[[Category:Disease]]
[[Category:Disease]]
[[Category:Neurology]]
[[Category:Neurology]]
[[Category:Primary care]]
[[Category:Primary care]]

Revision as of 21:05, 9 November 2015

Epidural abscess Microchapters

Home

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Epidural abscess from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Epidural abscess epidemiology and demographics On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Epidural abscess epidemiology and demographics

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Epidural abscess epidemiology and demographics

CDC on Epidural abscess epidemiology and demographics

Epidural abscess epidemiology and demographics in the news

Blogs on Epidural abscess epidemiology and demographics

Directions to Hospitals Treating Epidural abscess

Risk calculators and risk factors for Epidural abscess epidemiology and demographics

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]; Anthony Gallo, B.S. [3]

Overview

An epidural abscess is a rare suppurative infection of the central nervous system, a collection of pus localized in the epidural space, lying outside the dura mater, which accounts for less than 2% of focal central nervous system infections.[1] Spinal epidural abscess is rare, accounting for 2.5 to 3 cases per 10,000 hospital admissions per year.[2] Estimates of the incidence after central nerve block vary from 1 per 1,000 hospital admissions to 1 per 100,000 hospital admissions.[3] Prevalence is greatest between the fifth and seventh decades of life.[4]

Epidemiology And Demographics

Intracranial Epidural Abscess

Intracranial epidural abscess is the more rare type of epidural abscess, accounting for 1 out of 10 cases of the disease. However, it is the 3rd most common focal intracranial infection, following brain abscess and subdural empyema. Today it occurs most often following neurosurgical procedures and inIV drug users. Approximately 2% of patients with sinusitis developed some kind intracranial epidural abscess as a complication.[5]

Spinal Epidural Abscess

Spinal epidural abscess is the most common type of epidural abscess. Prevalence is greatest between the fifth and seventh decades of life with a male predominance of the disease.[4][6] Spinal epidural abscess is rare, accounting for 2.5 to 3 cases per 10,000 hospital admissions per year.[2]

References

  1. Longo, Dan L. (Dan Louis) (2012). Harrison's principles of internal medici. New York: McGraw-Hill. ISBN 978-0-07-174889-6.
  2. 2.0 2.1 Sampath P, Rigamonti D (1999). "Spinal epidural abscess: a review of epidemiology, diagnosis, and treatment". J Spinal Disord. 12 (2): 89–93. PMID 10229519. |access-date= requires |url= (help)
  3. Grewal S, Hocking G, Wildsmith JA (2006). "Epidural abscesses". Br J Anaesth. 96 (3): 292–302. doi:10.1093/bja/ael006. PMID 16431882. |access-date= requires |url= (help)
  4. 4.0 4.1 Danner RL, Hartman BJ (1987). "Update on spinal epidural abscess: 35 cases and review of the literature". Rev. Infect. Dis. 9 (2): 265–74. PMID 3589332. |access-date= requires |url= (help)
  5. Gallagher RM, Gross CW, Phillips CD (1998). "Suppurative intracranial complications of sinusitis". Laryngoscope. 108 (11 Pt 1): 1635–42. PMID 9818818.
  6. Darouiche RO, Hamill RJ, Greenberg SB, Weathers SW, Musher DM (1992). "Bacterial spinal epidural abscess. Review of 43 cases and literature survey". Medicine (Baltimore). 71 (6): 369–85. PMID 1359381.