Authors :
Manash Chakraborty; Sabin Yadav
Volume/Issue :
Volume 9 - 2024, Issue 11 - November
Google Scholar :
https://tinyurl.com/2s3jw5bw
Scribd :
https://tinyurl.com/d4usttjw
DOI :
https://doi.org/10.5281/zenodo.14351519
Abstract :
We are presenting a case of 74 years old
gentleman who had a robotic cystoprostatectomy with
ileal conduit and subsequently developed complicated
Staphylococcus bacteraemia. His post operative recovery
was slightly delayed due to paralytic ileus. Three days post
discharge he represented himself with features of
thrombophlebitis of forearm and septic shock requiring
admission to intensive care. This was complicated with
loss of vision and new onset neurological symptoms
including quadriplegia. Subsequent investigations
confirmed Staphylococcus bacteraemia leading to
atypical lung infection, endophthalmitis and epidural
abscess. He required intra-vitreal injection of antibiotics
and decompression of epidural abscess twice. He
completed a total of 6 weeks of IV antibiotics. Although,
his vision and upper limb function have improved, he
remains paraplegic. Staphylococcus aureus can cause
wide range of infection leading to serious complications in
immunocompromised patients. In our case, the only
identifiable source of the infection was the patient’s
peripheral venous cannulation site which is very unusual.
References :
- Darouiche, R. O. (2006). Spinal epidural abscess. N Engl J Med, 355(19), 2012-2020. https://doi.org/10.1056/NEJMra055111
- Davis, D. P., Wold, R. M., Patel, R. J., Tran, A. J., Tokhi, R. N., Chan, T. C., & Vilke, G. M. (2004). The clinical presentation and impact of diagnostic delays on emergency department patients with spinal epidural abscess. J Emerg Med, 26(3), 285-291. https://doi.org/10.1016/j.jemermed.2003.11.013
- Hal, S. J. v., Jensen, S. O., Vaska, V. L., Espedido, B. A., Paterson, D. L., & Gosbell, I. B. (2012). Predictors of Mortality in Staphylococcus aureus Bacteremia. Clinical Microbiology Reviews, 25(2), 362-386. https://doi.org/doi:10.1128/cmr.05022-11
- Huang, P. Y., Chen, S. F., Chang, W. N., Lu, C. H., Chuang, Y. C., Tsai, N. W., Chang, C. C., Wang, H. C., Chien, C. C., Chen, S. H., & Huang, C. R. (2012). Spinal epidural abscess in adults caused by Staphylococcus aureus: clinical characteristics and prognostic factors. Clin Neurol Neurosurg, 114(6), 572-576. https://doi.org/10.1016/j.clineuro.2011.12.006
- Löhr, M., Reithmeier, T., Ernestus, R. I., Ebel, H., & Klug, N. (2005). Spinal epidural abscess: prognostic factors and comparison of different surgical treatment strategies. Acta Neurochir (Wien), 147(2), 159-166; discussion 166. https://doi.org/10.1007/s00701-004-0414-1
- Reihsaus, E., Waldbaur, H., & Seeling, W. (2000). Spinal epidural abscess: a meta-analysis of 915 patients. Neurosurg Rev, 23(4), 175-204; discussion 205. https://doi.org/10.1007/pl00011954
- Tong, S. Y. C., Davis, J. S., Eichenberger, E., Holland, T. L., & Fowler, V. G. (2015). Staphylococcus aureus Infections: Epidemiology, Pathophysiology, Clinical Manifestations, and Management. Clinical Microbiology Reviews, 28(3), 603-661. https://doi.org/doi:10.1128/cmr.00134-14
We are presenting a case of 74 years old
gentleman who had a robotic cystoprostatectomy with
ileal conduit and subsequently developed complicated
Staphylococcus bacteraemia. His post operative recovery
was slightly delayed due to paralytic ileus. Three days post
discharge he represented himself with features of
thrombophlebitis of forearm and septic shock requiring
admission to intensive care. This was complicated with
loss of vision and new onset neurological symptoms
including quadriplegia. Subsequent investigations
confirmed Staphylococcus bacteraemia leading to
atypical lung infection, endophthalmitis and epidural
abscess. He required intra-vitreal injection of antibiotics
and decompression of epidural abscess twice. He
completed a total of 6 weeks of IV antibiotics. Although,
his vision and upper limb function have improved, he
remains paraplegic. Staphylococcus aureus can cause
wide range of infection leading to serious complications in
immunocompromised patients. In our case, the only
identifiable source of the infection was the patient’s
peripheral venous cannulation site which is very unusual.