RT Journal Article
SR Electronic
T1 Rogue one: a story of tophaceous gout in the spine
JF BMJ Case Reports
FD BMJ Publishing Group Ltd
SP bcr-2017-221163
DO 10.1136/bcr-2017-221163
VO 2018
A1 Dwarki, Karthik
A1 Dothard, Andy
A1 Abadie, Bryan
A1 Miles, Matthew C
YR 2018
UL http://casereports.bmj.com/content/2018/bcr-2017-221163.abstract
AB A 26-year-old man with history of extensive tophaceous gout presented to the referring facility with decreased bilateral lower extremity sensation and motor function that began acutely 1 week prior to admission and had progressed to urinary incontinence. The patient was admitted to the intensive care unit due to concern for sepsis secondary to epidural abscess. The patient was started on empiric vancomycin and cefepime. Neurosurgery did not recommend acute neurosurgical intervention given the lack of a compressive lesion. Aspiration of the paraspinal collection by interventional radiology subsequently showed crystals consistent with tophaceous gout. Given the high initial suspicion for gout and results of the paraspinal aspiration, the patient was started on prolonged steroid taper as well as allopurinol and colchicine. The patient eventually had partial neurological recovery with discharge to an inpatient rehabilitation facility for further physical therapy rehabilitation.