World J Emerg Surg 2008, 3:33 CrossRefPubMed 54

World J Emerg Surg 2008, 3:33.CrossRefPubMed 54. Fitzgibbons RJ Jr, Salerno GM, Filipi CJ, Hunter WJ, Watson P: A laparoscopic intraperitoneal onlay mesh technique for the repair of an indirect inguinal hernia. Ann Surg 1994,219(2):144–156.CrossRefPubMed 55. Shah R, Sabanathan S, Mearns AJ, Choudhury AK: Traumatic Rupture of the Diaphragm. Ann Thoracic Surgery 1995,60(5):1444–1449.AZD2014 order CrossRef Competing interests The authors declare that they have no competing interests. Authors’ contributions FR and MMC performed the literature search, extracted the data and wrote the manuscript. RS helped with radiological

images. SY Iftikhar performed ARRY-438162 mw the operation. FR, MMC, RS and SYI all helped in writing different subsections of the review. All authors contributed to the manuscript, and all read and approved the final version.”
“Background Spinal subdural abscess (SSA) is a very rare entity. Its exact incidence is unknown and to date only 64 cases have been reported in the literature [1]. Staphylococcus aureus (staph aureus) is the most common bacterial source [1–3] and thoraco – lumbar spine is the most affected region [1, 2, 4]. MRI is the diagnostic modality of choice. The first subdural empyema was reported in 1927 [5]. Bacterial abscesses VS-4718 involving

spinal canal are associated with high morbidity and mortality, while early diagnosis and emergent treatment are vital to prevent the formation and progression of neurologic deficits and death. In this report, we present a patient with SSA in the thoracic and lumbar region.

Case presentation A 75-year-old man with a past medical history of diabetes mellitus was admitted to the Emergency Department of our University Hospital. He had a history of acute low back pain in the region of the lumbar spine in the last 4 days before his admission to the hospital. Two days before his admission he experienced lower leg weakness and fever (oral temperature 38.5°C). Clinical examination showed neck stiffness. After initial evaluation and brain CT scan – which revealed no damage ID-8 – he had a lumbar puncture. The patient hospitalized with the diagnosis of meningitis (CSF: 765 white cells per cubic millimeter, elevated protein level: 70 mg per deciliter, decreased CSF glucose levels: 35% of serum glucose). Staph. aureus was cultured from cerebrospinal fluid (CSF) sample. The neurologic condition of the patient impaired very quickly and at the end of the third day, after his admission, he developed paraplegia. Deep tendon reflexes were absent in the lower limbs and severely diminished in the upper limbs. After neurosurgical consultation an emergency magnetic resonance imaging scan (MRI) of the brain and the whole spinal spine was performed, five days after the admission of the patient to the hospital.

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