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Holospinal epidural abscess caused by Streptococcus anginosus group: a literature review
  1. Keisuke Maeda1,
  2. Shota Kikuta2,
  3. Shigenari Matsuyama2 and
  4. Satoshi Ishihara2
  1. 1Emergency Medicine, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
  2. 2Emergency and Critical Care Medicine, Hyogo Emergency Medical Center, Kobe, Hyogo, Japan
  1. Correspondence to Dr Shota Kikuta; kikukikukikuun{at}


Spinal epidural abscess (SEA) usually extends over three to four vertebrae. We present a case of holospinal epidural abscess (HEA) caused by the Streptococcus anginosus group (SAG). A man in his 40s with a 2-week history of fever, back pain, and progressive tetraparesis was referred to us from the local hospital. MRI showed epidural fluid collection from C2 to S1. Blood and pus cultures revealed the presence of SAG. He was treated by emergency laminoplasty, epidural drainage and antibiotic treatment. After the 111st hospital day, his manual muscle test was shown to improve; hence, he was transferred for rehabilitation. According to the previous reports, we identified 12 cases of SEA extending from the cervical spine to the sacrum, including our case. For one-fourth of these cases, SAG was the causative organism of this rare SEA. Therefore, SAG should be considered causative organisms in HEA.

  • Infectious diseases
  • Orthopaedic and trauma surgery
  • Orthopaedics

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  • Contributors KM and SK were in charge of this patients’ admission and equally contributed to writing this article. SM and SI are contributed to the treatment planning of his condition.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.