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Abscess of the Cervical Spine Caused by Klebsiella Peumoniae with Acute Compressive Flexion Injury - A Case Report -

  • Journal of Korean Society of Spine Surgery
  • Abbr : J Kor Spine Sur
  • 2017, 24(4), pp.236-240
  • Publisher : Korean Society Of Spine Surgery
  • Research Area : Medicine and Pharmacy > Orthopedic Surgery

Min Woo Kim 1,  이규열 1

1동아대학교 의과대학 정형외과학교실

Accredited

ABSTRACT

Study Design: Case report. Objectives: To report an unusual case of an abscess of the cervical spine caused by Klebsiella peumoniae accompanied by an acute compressive flexion injury. Summary of Literature Review: Spondylitis caused by Klebsiella peumoniae is very rare, and an unrecognized epidural abscess complicated with spinal cord compression can lead to severe neurologic deficits. Materials and Methods: A 66-year-old male patient diagnosed with a liver abscess caused by Klebsiella peumoniae was referred from the internal medicine department to our department due to abrupt posterior neck pain and limitation of motion after a fall from the bed. He showed persistent fever and progressive dysphagia. We diagnosed the condition as a massive cervical abscess caused by Klebsiella peumoniae accompanied by an acute compressive flexion injury. We performed drainage of the massive abscess, anterior fusion to treat the loss of the intervertebral discs at the C3/4 level, and corpectomy for a compression fracture of the C6 vertebral body using a cage and plate via an anterior approach. Subsequently, we performed posterior laminectomy with drainage at the C3-6 level and posterior instrumentation of C2-7 via a posterior approach. Results: Starting on the second postoperative day, the patient showed a decreased fever and gradual restoration of muscle strength and function in the upper extremities and hands. Conclusions: Klebsiella peumoniae may cause spinal infection as an opportunistic infection in patients with impaired immune function, and cervical infections in particular require aggressive early treatment because serious neurological symptoms may occur, even in cases of minor trauma.

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