Author:
Pietro Domenico Giorgi,Giuseppe Rosario Schirò,Davide Colistra,Simona Legrenzi,Jacopo Falco,Maria Ludovica Pallotta,Giuseppe Talamonti
Abstract
During the SARS-CoV-2 pandemic, some authors described an increased incidence of primary Spinal Epidural Abscess (SEA) in COVID-19 patients with clinical and radiological peculiarities. Early recognition of this disease remains challenging, resulting in delayed diagnosis and significant morbidity and mortality. The authors performed a systematic review of the literature in PubMed, Cochrane, and Scopus about the traditional form of SEA comparing the main features related to COVID-19 SEA. The search was performed from 1990 to 2020. Magnetic Resonance Imaging with contrast is mandatory to recognize this kind of lesion in order to obtain a differential diagnosis. COVID-19 SEAs are generally active abscesses, with a large cystic component. Gadolinium-enhanced MR images can aid in the definition of the age and consistency of the abscess. A rim of tissue that enhances after the injection of gadolinium represents granulation tissue; liquid pus is associated with an area of low signal intensity on T1-weighted images. This new type of SEA in COVID-19 patients showed several differences also in clinical features. No evidence of an external infective source was found (spondylodiscitis, surgery, or percutaneous treatment). None of the patients was a drug abuser and MSSA was the only responsible pathogen. The cervicothoracic spine was the most involved site. Further studies are needed to confirm these preliminary findings.
Publisher
Peertechz Publications Private Limited
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