PURULENT EPIDURITIS: CASE HISTORY IN GENERAL PRACTITIONER PRACTICE

Relevance. Back and neck pain is one of the most common reasons of visiting a doctor. Pain syndrome is mostly related to lesion of the musculoskeletal system components, but may be due to specific reasons as traumas, systemic inflammatory diseases, tumors, etc. The reasons of spinal pain may be spinal infections which refer to quite rare and difficult to diagnose diseases. A doctor should be concerned of the spinal infection in order to suspect this abnormality and to send a patient for respective examination. Case descriptions. The article presents a case of purulent epiduritis in a patient with chronic urological pathology. Difficulties in diagnosis were related to non-specific clinical symptoms of the disease, missing sings of the infection process in the spine as shown by computed tomography, presence of infection site of other localization. The patient was hospitalized in the therapeutic department with the diagnosis: Diabetes mellitus type 2, newly diagnosed. Vertebrogenic cervicobrachialgia on the left, exacerbation. Benign prostatic hyperplasia. Acute urinary retention. Chronic obstructive pyelonephritis, exacerbation. Antibacterial therapy, insulin therapy, and symptomatic therapy were administered. Intoxication, neurological symptoms, laboratory activity were observed during the therapy. The patient underwent MRI examination which resulted to diagnosing epiduritis of cervical and thoracic spine. Antimicrobial therapy regimen was changed which resulted to regression of neurological symptoms, pain syndrome, positive laboratory dynamics was observed. The patient was discharged following completion of intravenous therapy with recommendations on further treatment on outpatient basis. Conclusion. This clinical observation demonstrates the difficulties in diagnosing purulent-inflammatory disease of the spine in a patient with chronic urological pathology undergoing treatment in the therapeutic department. Magnetic resonance examination was crucial in establishing the correct diagnosis. The conservative therapy with antimicrobial agents was effective in this case; no surgical treatment was required.