Cervical Spinal Epidural Abscess and Perirenal Abscess Associated with Diabetes Mellitus

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A 56-year-old woman was admitted due to fever, thirst, polydipsia, polyuria, posterior cervical pain and lumbago. Hyperglycemia and urine white blood cell elevation were detected. Computed tomography showed left perirenal abscess. Urine culture and blood culture revealed Escherichia coli. We diagnosed perirenal abscess followed by pyelonephritis due to untreated diabetes mellitus. We used 6g of ampicillin-sulbactum daily and from the 10th day 4g of sulfamethoxazole-trimethoprim for perirenal abscess, and 180mg of loxoprofen sodium daily for posterior cervical pain in addition to a diabetic diet and insulin therapy for diabetes mellitus. Although the patients fever normalized and lumbago improved, posterior cervical pain level increased and bilateral 1, 2 and 3 finger-numbness occurred from the 18th day. Cervical magnetic resonance imaging showed cervical 4, 5 and 6 vertebra inflammation induced spine compression. Removal of the cervical abscess and fixation of the vertebra were performed at the 27th day. Treating diabetes mellitus is important for the prevention of severe infection.
北関東医学会の論文