Artritis séptica facetaria y síndrome de cauda equina.

Abstract

Septic arthritis of the facet joint is one of the least diagnosed back pain causes, and hence least described in the bibliography. As in most osteoarticular diseases Staphylococcus aureus methicillin sensitive (MSSA) is the principal pathogen and is usually disseminated through the blood stream. We report a 48 year old man, without comorbidities, who presented septic arthritis of the L4-L5 facet joint along with paravertebral and epidural abscesses caused by Sthaphylococcus aureus methicillin resistant (MRSA), which is an uncommon aetiology of community-adquired infections, as well as bacteraemia followed by Adult Respiratory Distress Syndrome. The diagnosis was also confirmed by a magnetic resonance imaging (MRI). The latter showed a narrowness of the spinal cord in the height of the L4-L5 facet joints, which though being asymptomatic until that moment developed to Cauda Equina Syndrome. The patient was given Linezolid, parenterally for the first four, and orally for the following four weeks, along with abscess drainage and surgical treatment. The evolution was good showing persisting urinary incontinence and residual neuropathic pain with no other deficit at discharge from the hospital.