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A 2-month-old male domestic shorthair cat was referred to a private veterinary clinic with a history of dyspnea and inappetence. At the clinical examination, the cat was in poor body condition, with hyperthermia and abdominal distension. No major abnormalities were observed in the thoracic radiographs or abdominal ultrasound. A complete blood count revealed leukocytosis with neutrophilia. Although no clinical diagnosis was made, the cat received support therapy, but went into cardiac arrest and died. The cat was submitted for necropsy and the main gross finding was two white nodules on the ventral surface of the thoracic vertebrae (from T1 to T4). At the cut surface, the nodules were friable and filled with yellow exudate. The epidural space of the thoracic region was filled with yellowish viscous material. Histologically, the vertebrae were partially replaced by abscess formation characterized by a necrotic center with degenerate neutrophils, surrounded by fibrous connective tissue. The epidural space was filled with degenerate neutrophils, necrotic debris, fibrin, and intralesional colonies of gram-negative short rod-shaped to coccobacillary bacteria. Bacteriologic culture yielded Pasteurella multocida. This paper describes the gross, histological, and bacteriological features of a rare case of spinal epidural empyema caused by Pasteurella multocida in a cat.(AU)

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We present a case of a patient with diabetes with a pleural empyema originated from a pyomyositis process established after a central line procedure. This empyema later on extended into the spinal canal deriving into an epidural empyema, leading towards a spinal neurogenic shock and death. We discuss the anatomical substrate for this extension as well as the anatomopathological findings observed in the autopsy.

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Introdução: Dentre as complicações da rinossinusite, as orbitárias são as mais frequentes, e estas, ocorrem na maioria dos casos entre jovens e crianças. Complicações simultâneas envolvendo a órbita e o espaço intracraniano são extremamente raras, mas devem ser tratadas agressivamente pois oferecem alta taxa de morbidade e mortalidade. Relato do Caso: Neste trabalho, os autores relatam um caso de um paciente que se apresentou com celulite pré-septal e abscesso epidural, como complicações simultâneas de uma rinossinusite aguda. No paciente deste estudo, optou-se pelo tratamento clínico associado à cirurgia endoscópica nasossinusal e drenagem neurocirúrgica do abscesso intracraniano. A TC foi suficiente no caso apresentado para a realização do diagnóstico. Comentários Finais: Recomenda-se entretanto, que nos casos de pacientes com complicações da rinossinusite, a investigação da extensão intracraniana seja aprofundada, mesmo quando esta, a princípio não seja tão evidente. Dada a natureza polimicrobiana dessas infecções, uma antibioticoterapia agressiva guiada por cultura e um acompanhamento por equipe multidisciplinar, aumentam consideravelmente as chances de sucesso.

Introduction: Among the rhinosinusitis complications, the orbital are the most frequent ones, occurring mostly in the youngsters and children. Simultaneous complications involving the intracranial orbit and space are extremely rare, but they must be severely treated for they have a high rate of morbidity and mortality. Case report: In this work, the authors report a case of a patient who appeared to have preseptal cellulites and epidural abscess, in the form of simultaneous complications of an acute rhinosinusitis. In the patient of this case, choice was made for a clinic treatment associated with a nasosinusal endoscopic surgery and neurosurgical drainage of the intracranial abscess. CT was enough to achieve the diagnosis of this case. Final commentaries: However, it is recommended that, in cases where patients have rhinosinusitis complications, an extensive intracranial investigation needs to be deepened even when this is not so evident in the beginning. Given the polymicrobial nature of these infections, an aggressive culture-guided antibiotic therapy and a multidisciplinary follow-up significantly increase the likelihood of success.

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BACKGROUND CONTEXT: Spinal epidural abscess is an uncommon infection. There are few reports on extensive epidural abscesses. PURPOSE: We report a case of an epidural abscess extending from C2 to the sacrum, with a long-term follow-up. STUDY DESIGN: A case report of an extensive epidural abscess with surgical treatment. METHODS: A 36-year-old male patient presented with a history of 15 days of fever and severe lumbar and neck pain. Magnetic resonance imaging disclosed an epidural abscess extending from C2 to the sacrum. Limited laminectomies were performed in the cervical, thoracic, and lumbar spine, and pus was obtained. A peptostreptococus grew in cultures. The patient received 6 weeks of antibiotics. RESULTS: The infection was successfully treated, and no neurological deficit was observed. The patient continued asymptomatic 5 years after surgery, and no deformity has developed. CONCLUSIONS: A case of an extensive epidural abscess was successfully treated with limited laminectomies and antibiotics. This less invasive technique could treat the infection, and no late deformity has been observed.

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Presentamos el caso de un paciente que fue sometido a anestesia regional con catéter epidural para cirugía de corrección de hernia inguinal y umbilical y que luego de tres días presentara cuadro clínico de lumbo ciatalgia, con mas de veinte días de evolución, progresiva a dificultad para deambular, parestesias en miembros inferiores, pérdida de fuerza y fiebre por lo que ingresado a UCI, demostrándose luego la presencia de micro abscesos epidurales por RM y compromiso inflamatorio vertebro discal, cuadro asociado a proceso asmático, hipertrofia de próstata e infección urinaria.

We present the case of a patient that was subjected to Regional Anesthesia with Catheter epidural for Surgery of Correction of Hernia Inguinal and Umbilical and that after 3 days it presented clinical square of Lumbo ciatalgia, with but of twenty days of evolution, progressive to difficulty to stroll, parestesias in inferior members, lost of force and fever for what is entered to ICU, being demonstrated the presence of micro abscesses Epidurals then by RM and commitment inflammatory vertebro discal, square associated to asthmatic process, prostate Hipertrofia and Urinary Infection.

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