Vertebral osteomyelitis resulting in cauda equina syndrome and urinary retention
Diagnosis almost certain
Presentation
6 weeks of urinary retention managed with foley catheter, evaluate for cause.
Patient Data
Age: 70 years
Gender: Male
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L3/L4 endplate destruction with paraspinal abscess and phlegmon, resulting in severe narrowing of the spinal canal.
Bladder decompressed with foley catheter. Mild bilateral hydroureteronephrosis.
Case Discussion
Cauda equina syndrome due to paraspinal phlegmon/abscess causing lumbosacral nerve root compression, resulting in several weeks of urinary retention. The patient did not complain of back pain at the time of presentation, and was instead thought to have BPH as the cause. This is considered a diagnostic and surgical emergency, as decompression within 24 hours typically has the best outcomes.
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