{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T05:51:04Z","timestamp":1783403464031,"version":"3.54.6"},"reference-count":17,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,8,11]]},"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:p>Spinal epidural abscess (SEA) is a surgical emergency if it causes paraplegia. <jats:italic>Staphylococcus aureus<\/jats:italic> and streptococci are the most common causes. <jats:italic>Streptococcus gallolyticus<\/jats:italic> has been reported to cause SEA only on three occasions earlier\u2014all were associated with endocarditis or colonic malignancy. We report an older woman with diabetic ketoacidosis who presented with poorly localised back pain, fever and altered sensorium. Her lumbar puncture revealed frank pus, and MRI showed an SEA. She could not be weaned from mechanical ventilation post-surgical decompression, and she succumbed to ventilator-associated pneumonia. A triad of fever, back pain and neurological deficit should lead one to consider intraspinal suppuration. This report is the first <jats:italic>S. gallolyticus<\/jats:italic>-related SEA from India and the first in literature that was not associated with either endocarditis or colonic malignancy.<\/jats:p>","DOI":"10.1136\/bcr-2022-250733","type":"journal-article","created":{"date-parts":[[2022,8,23]],"date-time":"2022-08-23T12:16:59Z","timestamp":1661257019000},"page":"e250733","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["<i>Streptococcus gallolyticus<\/i>-related spinal epidural abscess"],"prefix":"10.1136","volume":"15","author":[{"given":"Vineet","family":"Agrawal","sequence":"first","affiliation":[{"name":"Department of General Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5861-5161","authenticated-orcid":false,"given":"Stalin","family":"Viswanathan","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4076-3718","authenticated-orcid":false,"given":"Jayachandran","family":"Selvaraj","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivekanandan","family":"Pillai","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,8,23]]},"reference":[{"key":"2025082800235025000_15.8.e250733.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra055111"},{"key":"2025082800235025000_15.8.e250733.2","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcm100"},{"key":"2025082800235025000_15.8.e250733.3","doi-asserted-by":"crossref","DOI":"10.4103\/sni.sni_105_17","article-title":"Spinal epidural abscess: report on 27 cases","volume":"8","author":"Khursheed","year":"2017","journal-title":"Surg Neurol Int"},{"key":"2025082800235025000_15.8.e250733.4","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02977-15"},{"key":"2025082800235025000_15.8.e250733.5","article-title":"Spinal epidural abscess in melioidosis: a rare case report from eastern India","volume":"11","author":"Prabhat","year":"2019","journal-title":"Cureus"},{"key":"2025082800235025000_15.8.e250733.6","doi-asserted-by":"crossref","first-page":"943","DOI":"10.5005\/jp-journals-10071-23569","article-title":"Streptococcus gallolyticus Bacteremia: An Experience from a Tertiary Center in South India","volume":"24","author":"Niyas","year":"2020","journal-title":"Indian J Crit Care Med"},{"key":"2025082800235025000_15.8.e250733.7","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-019-4413-5"},{"key":"2025082800235025000_15.8.e250733.8","doi-asserted-by":"publisher","DOI":"10.1155\/2011\/972494"},{"key":"2025082800235025000_15.8.e250733.9","doi-asserted-by":"crossref","first-page":"2336","DOI":"10.1007\/s10620-006-9287-x","article-title":"Streptococcus bovis endophthalmitis: a unique presentation of colon cancer","volume":"52","author":"Bleibel","year":"2007","journal-title":"Dig Dis Sci"},{"key":"2025082800235025000_15.8.e250733.10","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/39.3.338"},{"key":"2025082800235025000_15.8.e250733.11","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1136\/hrt.80.3.276","article-title":"Clinical and morphological characteristics in Streptococcus bovis endocarditis: a comparison with other causative microorganisms in 177 cases","volume":"80","author":"Kupferwasser","year":"1998","journal-title":"Heart"},{"key":"2025082800235025000_15.8.e250733.12","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-002-0798-x"},{"key":"2025082800235025000_15.8.e250733.13","doi-asserted-by":"crossref","unstructured":"Santos MM , Belo D , Cruz S . 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