K.V Shivanand Reddy

K.V Shivanand Reddy

JSS Hospital Mysore, India

Title: CASE REPORT: Nocardia in Spinal Epidural Abscess: A Surprise Guest


Dr K V Shivanand Reddy has completed M.B.B.S at the age of 23 years from Rajiv Gandhi University,Bangalore and doing his residency in General Surgery from JSS Medical College ,Mysore. He has published more than 10 papers in reputed journals.


Spinal epidural abscess (SEA) is a rare neurosurgical emergency condition which accounts for 2.5 – 3 cases per 10 000 hospital admissions per year1. Early diagnosis and treatment has better outcome. Delayed diagnosis or inadequate treatment results in long term severe or disabling neurological deficits. The reason for recent rise in incidence of spinal epidural abscess includes, the growth of elderly population, multiple chronic medical conditions, intravenous drug abuse, indwelling intravenous catheters, increase in transplant recipients and use of immunosuppressive drugs. Spinal epidural abscess is primarily a bacterial infection, Staphylococcus aureus being the most common causative agent. Other organisms such as Staphylococcus epidermidis, Streptococcus viridians, Strptococcus pneumoniae, E. faecalis, Propionibacterium and Gram negative organisms such as Escherichia coli, Pseudomonas, Salmonella, Enterobacter, Klebsiella, Haemophilus, Proteus also cause SEA2. Nocardiosis of CNS is a very rare. Nocardia is a Gram positive aerobic actinomycete which belongs to the genus Nocardia. Infection by this organism usually occurs in patients with impaired immunity. Improvement in recent diagnostic techniques has helped in isolation of the organism more frequently. Magnetic resonance imaging(MRI) has markedly enhanced the ability to detect these conditions, allowing earlier diagnosis, thereby avoiding complications. A 22 year old male patient was admitted to our hospital with chief complaints of fever, cough and breathlessness of 2 weeks duration.He was diagnosed to be nephrotic syndrome and later he developed epidural abscess from D6 to D 12 level,it was drained surgically and managed by higher antibiotics.This is a rare entity to be found.

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