{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T12:43:06Z","timestamp":1789821786995,"version":"4.0.1"},"reference-count":38,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"16","license":[{"start":{"date-parts":[[2024,10,14]],"date-time":"2024-10-14T00:00:00Z","timestamp":1728864000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2024,10,14]]},"abstract":"\n BACKGROUND<\/jats:title>\n Spinal subdural empyemas are a rare presentation of rapid neurological decline, progressing from radiculopathy to complete paralysis and sensory loss. Although pathogenic mechanisms have been hypothesized, their occurrence in this population of patients remains unclear.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n The authors present the third documented case of an isolated spinal subdural empyema of unclear etiology in an immunocompetent patient with no established risk factors.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n Successful treatment requires prompt clinical suspicion, radiological diagnosis, and surgical evacuation along with empirical antibiotic treatment. Radiological clarification of the subdural versus the epidural location of the empyema is difficult, while intraoperative durotomy for exploration risks subdural dissemination. In these cases, intraoperative ultrasonography would be a useful adjunct and decision aid.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE24464<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case24464","type":"journal-article","created":{"date-parts":[[2024,10,14]],"date-time":"2024-10-14T02:44:48Z","timestamp":1728873888000},"source":"Crossref","is-referenced-by-count":1,"title":["Spinal subdural empyema in an immunocompetent patient: illustrative case"],"prefix":"10.3171","volume":"8","author":[{"given":"Shreyas","family":"Thiruvengadam","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Sir Charles Gairdner Hospital, Perth, Western Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boyuan","family":"Khoo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sir Charles Gairdner Hospital, Perth, Western Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Snigdha","family":"Saha","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sir Charles Gairdner Hospital, Perth, Western Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"2","key":"bib1","series-title":"J Neurosurg","first-page":"307","article-title":"Spinal subdural abscess: case report","volume":"76","author":"Bartels","year":"1992","unstructured":"Bartels RHde Jong TRGrotenhuis JA. Spinal subdural abscess: case report. J Neurosurg. 1992;76(2):307-311."},{"key":"bib2","series-title":"World Neurosurg","first-page":"326","article-title":"Rare concurrent retroclival and pan-spinal subdural empyema: review of literature with an uncommon illustrative case","volume":"110","author":"Mortazavi","year":"2018","unstructured":"Mortazavi MMQuadri SASuriya SS, et al. Rare concurrent retroclival and pan-spinal subdural empyema: review of literature with an uncommon illustrative case. World Neurosurg. 2018;110:326-335."},{"issue":"1","key":"bib3","series-title":"Childs Nerv Syst","first-page":"105","article-title":"Infections of the spinal subdural space in children: a series of 11 contemporary cases and review of all published reports. A multinational collaborative effort","volume":"29","author":"Sandler","year":"2013","unstructured":"Sandler ALThompson DGoodrich JT, et al. Infections of the spinal subdural space in children: a series of 11 contemporary cases and review of all published reports. A multinational collaborative effort. Childs Nerv Syst. 2013;29(1):105-117."},{"issue":"1","key":"bib4","series-title":"Orthop Clin North Am","first-page":"125","article-title":"Neurosurgical care of spinal epidural, subdural, and intramedullary abscesses and arachnoiditis","volume":"27","author":"Martin","year":"1996","unstructured":"Martin RJYuan HA. Neurosurgical care of spinal epidural, subdural, and intramedullary abscesses and arachnoiditis. Orthop Clin North Am. 1996;27(1):125-136."},{"issue":"6","key":"bib5","series-title":"J Neurosurg","first-page":"929","article-title":"Subdural empyema of the cervical spine: clinicopathological correlates and magnetic resonance imaging. Report of three cases","volume":"79","author":"Levy","year":"1993","unstructured":"Levy MLWieder BHSchneider JZee CSWeiss MH. Subdural empyema of the cervical spine: clinicopathological correlates and magnetic resonance imaging. Report of three cases. J Neurosurg. 1993;79(6):929-935."},{"issue":"1","key":"bib6","series-title":"Z Gesamte Neurol Psychiatr","first-page":"146","article-title":"Metastatischer R\u00fcckenmarksabsce\u00df bei septischem Abortus","volume":"107","author":"Sittig","year":"1927","unstructured":"Sittig O. Metastatischer R\u00fcckenmarksabsce\u00df bei septischem Abortus. Z Gesamte Neurol Psychiatr. 1927;107(1):146-151."},{"issue":"3","key":"bib7","series-title":"Open J Mod Neurosurg","first-page":"112","article-title":"Isolated spinal subdural empyema: a case report & review of the literature","volume":"7","author":"Marciano","year":"2017","unstructured":"Marciano RDBuster WKaras CNarayan K. Isolated spinal subdural empyema: a case report & review of the literature. Open J Mod Neurosurg. 2017;7(3):112-119."},{"issue":"5","key":"bib8","series-title":"Acta Neurol Scand","first-page":"343","article-title":"Spinal subdural Staphylococcus aureus abscess: case report and review of the literature","volume":"112","author":"Vural","year":"2005","unstructured":"Vural MArslanta\u015f AAdapinar B, et al. Spinal subdural Staphylococcus aureus abscess: case report and review of the literature. Acta Neurol Scand. 2005;112(5):343-346."},{"issue":"3","key":"bib9","series-title":"J Clin Neurosci","first-page":"292","article-title":"Spinal subdural abscess: a rare cause of low back pain","volume":"15","author":"Sorar","year":"2008","unstructured":"Sorar MEr USe\u00e7kin HOzturk MHBavbek M. Spinal subdural abscess: a rare cause of low back pain. J Clin Neurosci. 2008;15(3):292-294."},{"issue":"13","key":"bib10","series-title":"Spine","first-page":"1668","article-title":"Hematogenous pyogenic spinal infections and their surgical management","volume":"25","author":"Hadjipavlou","year":"2000","unstructured":"Hadjipavlou AGMader JTNecessary JTMuffoletto AJ. Hematogenous pyogenic spinal infections and their surgical management. Spine. 2000;25(13):1668-1679."},{"issue":"4","key":"bib11","series-title":"Spine J","first-page":"e275","article-title":"Concomitant epidural and subdural spinal abscess: a case report","volume":"16","author":"Ngwenya","year":"2016","unstructured":"Ngwenya LBPrevedello LMYoussef PP. Concomitant epidural and subdural spinal abscess: a case report. Spine J. 2016;16(4):e275-e282."},{"issue":"2","key":"bib12","series-title":"Br J Neurosurg","first-page":"196","article-title":"Spinal epidural empyema","volume":"17","author":"Pilkington","year":"2003","unstructured":"Pilkington SAJackson SAGillett GR. Spinal epidural empyema. Br J Neurosurg. 2003;17(2):196-200."},{"issue":"3","key":"bib13","series-title":"J Emerg Med","first-page":"384","article-title":"Spinal epidural abscess","volume":"39","author":"Tompkins","year":"2010","unstructured":"Tompkins MPanuncialman ILucas PPalumbo M. Spinal epidural abscess. J Emerg Med. 2010;39(3):384-390."},{"issue":"1","key":"bib14","series-title":"Curr Treat Options Neurol","first-page":"13","article-title":"Subdural empyema","volume":"5","author":"Greenlee","year":"2003","unstructured":"Greenlee JE. Subdural empyema. Curr Treat Options Neurol. 2003;5(1):13-22."},{"issue":"3","key":"bib15","series-title":"Quant Imaging Med Surg","first-page":"261","article-title":"Intraoperative ultrasound in spine surgery: history, current applications, future developments","volume":"8","year":"2018","unstructured":"Ganau M, Syrmos N, Martin AR, Jiang F, Fehlings MG. Intraoperative ultrasound in spine surgery: history, current applications, future developments. Quant Imaging Med Surg. 2018;8(3):261-267."},{"issue":"5","key":"bib16","series-title":"AJR Am J Roentgenol","first-page":"907","article-title":"Ultrasonic visualization of a cervical cord cystic astrocytoma","volume":"131","author":"Reid","year":"1938","unstructured":"Reid MHUltrasonic visualization of a cervical cord cystic astrocytoma. AJR Am J Roentgenol. 1938;131(5):907-908."},{"issue":"3","key":"bib17","series-title":"Radiology","first-page":"609","article-title":"Subdural empyema in 10 infants: US characteristics and clinical correlates","volume":"207","author":"Chen","year":"1998","unstructured":"Chen CYHuang CCChang YCChow NHChio CCZimmerman RA. Subdural empyema in 10 infants: US characteristics and clinical correlates. Radiology. 1998;207(3):609-617."},{"issue":"1","key":"bib18","series-title":"World J Emerg Surg","first-page":"1","article-title":"Spinal subdural staphylococcus aureus abscess: case report and review of the literature","volume":"4","author":"Velissaris","year":"2009","unstructured":"Velissaris DAretha DFligou FFilos KS. Spinal subdural staphylococcus aureus abscess: case report and review of the literature. World J Emerg Surg. 2009;4(1):1-5."},{"issue":"1","key":"bib19","series-title":"Asian J Neurosurg","first-page":"58","article-title":"Infected epidural hematoma of the lumbar spine associated with invasive pneumococcal disease","volume":"10","author":"Inamasu","year":"2015","unstructured":"Inamasu JShizu NTsutsumi YHirose Y. Infected epidural hematoma of the lumbar spine associated with invasive pneumococcal disease. Asian J Neurosurg. 2015;10(1):58-58."},{"issue":"2","key":"bib1","series-title":"J Neurosurg","first-page":"307","article-title":"Spinal subdural abscess: case report","volume":"76","author":"Bartels","year":"1992","unstructured":"Bartels RHde Jong TRGrotenhuis JA. Spinal subdural abscess: case report. J Neurosurg. 1992;76(2):307-311."},{"key":"bib2","series-title":"World Neurosurg","first-page":"326","article-title":"Rare concurrent retroclival and pan-spinal subdural empyema: review of literature with an uncommon illustrative case","volume":"110","author":"Mortazavi","year":"2018","unstructured":"Mortazavi MMQuadri SASuriya SS, et al. Rare concurrent retroclival and pan-spinal subdural empyema: review of literature with an uncommon illustrative case. 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Orthop Clin North Am. 1996;27(1):125-136."},{"issue":"6","key":"bib5","series-title":"J Neurosurg","first-page":"929","article-title":"Subdural empyema of the cervical spine: clinicopathological correlates and magnetic resonance imaging. Report of three cases","volume":"79","author":"Levy","year":"1993","unstructured":"Levy MLWieder BHSchneider JZee CSWeiss MH. Subdural empyema of the cervical spine: clinicopathological correlates and magnetic resonance imaging. Report of three cases. J Neurosurg. 1993;79(6):929-935."},{"issue":"1","key":"bib6","series-title":"Z Gesamte Neurol Psychiatr","first-page":"146","article-title":"Metastatischer R\u00fcckenmarksabsce\u00df bei septischem Abortus","volume":"107","author":"Sittig","year":"1927","unstructured":"Sittig O. Metastatischer R\u00fcckenmarksabsce\u00df bei septischem Abortus. Z Gesamte Neurol Psychiatr. 1927;107(1):146-151."},{"issue":"3","key":"bib7","series-title":"Open J Mod Neurosurg","first-page":"112","article-title":"Isolated spinal subdural empyema: a case report & review of the literature","volume":"7","author":"Marciano","year":"2017","unstructured":"Marciano RDBuster WKaras CNarayan K. Isolated spinal subdural empyema: a case report & review of the literature. Open J Mod Neurosurg. 2017;7(3):112-119."},{"issue":"5","key":"bib8","series-title":"Acta Neurol Scand","first-page":"343","article-title":"Spinal subdural Staphylococcus aureus abscess: case report and review of the literature","volume":"112","author":"Vural","year":"2005","unstructured":"Vural MArslanta\u015f AAdapinar B, et al. Spinal subdural Staphylococcus aureus abscess: case report and review of the literature. Acta Neurol Scand. 2005;112(5):343-346."},{"issue":"3","key":"bib9","series-title":"J Clin Neurosci","first-page":"292","article-title":"Spinal subdural abscess: a rare cause of low back pain","volume":"15","author":"Sorar","year":"2008","unstructured":"Sorar MEr USe\u00e7kin HOzturk MHBavbek M. Spinal subdural abscess: a rare cause of low back pain. J Clin Neurosci. 2008;15(3):292-294."},{"issue":"13","key":"bib10","series-title":"Spine","first-page":"1668","article-title":"Hematogenous pyogenic spinal infections and their surgical management","volume":"25","author":"Hadjipavlou","year":"2000","unstructured":"Hadjipavlou AGMader JTNecessary JTMuffoletto AJ. Hematogenous pyogenic spinal infections and their surgical management. Spine. 2000;25(13):1668-1679."},{"issue":"4","key":"bib11","series-title":"Spine J","first-page":"e275","article-title":"Concomitant epidural and subdural spinal abscess: a case report","volume":"16","author":"Ngwenya","year":"2016","unstructured":"Ngwenya LBPrevedello LMYoussef PP. Concomitant epidural and subdural spinal abscess: a case report. Spine J. 2016;16(4):e275-e282."},{"issue":"2","key":"bib12","series-title":"Br J Neurosurg","first-page":"196","article-title":"Spinal epidural empyema","volume":"17","author":"Pilkington","year":"2003","unstructured":"Pilkington SAJackson SAGillett GR. Spinal epidural empyema. Br J Neurosurg. 2003;17(2):196-200."},{"issue":"3","key":"bib13","series-title":"J Emerg Med","first-page":"384","article-title":"Spinal epidural abscess","volume":"39","author":"Tompkins","year":"2010","unstructured":"Tompkins MPanuncialman ILucas PPalumbo M. Spinal epidural abscess. J Emerg Med. 2010;39(3):384-390."},{"issue":"1","key":"bib14","series-title":"Curr Treat Options Neurol","first-page":"13","article-title":"Subdural empyema","volume":"5","author":"Greenlee","year":"2003","unstructured":"Greenlee JE. Subdural empyema. Curr Treat Options Neurol. 2003;5(1):13-22."},{"issue":"3","key":"bib15","series-title":"Quant Imaging Med Surg","first-page":"261","article-title":"Intraoperative ultrasound in spine surgery: history, current applications, future developments","volume":"8","year":"2018","unstructured":"Ganau M, Syrmos N, Martin AR, Jiang F, Fehlings MG. Intraoperative ultrasound in spine surgery: history, current applications, future developments. Quant Imaging Med Surg. 2018;8(3):261-267."},{"issue":"5","key":"bib16","series-title":"AJR Am J Roentgenol","first-page":"907","article-title":"Ultrasonic visualization of a cervical cord cystic astrocytoma","volume":"131","author":"Reid","year":"1938","unstructured":"Reid MHUltrasonic visualization of a cervical cord cystic astrocytoma. AJR Am J Roentgenol. 1938;131(5):907-908."},{"issue":"3","key":"bib17","series-title":"Radiology","first-page":"609","article-title":"Subdural empyema in 10 infants: US characteristics and clinical correlates","volume":"207","author":"Chen","year":"1998","unstructured":"Chen CYHuang CCChang YCChow NHChio CCZimmerman RA. Subdural empyema in 10 infants: US characteristics and clinical correlates. Radiology. 1998;207(3):609-617."},{"issue":"1","key":"bib18","series-title":"World J Emerg Surg","first-page":"1","article-title":"Spinal subdural staphylococcus aureus abscess: case report and review of the literature","volume":"4","author":"Velissaris","year":"2009","unstructured":"Velissaris DAretha DFligou FFilos KS. Spinal subdural staphylococcus aureus abscess: case report and review of the literature. World J Emerg Surg. 2009;4(1):1-5."},{"issue":"1","key":"bib19","series-title":"Asian J Neurosurg","first-page":"58","article-title":"Infected epidural hematoma of the lumbar spine associated with invasive pneumococcal disease","volume":"10","author":"Inamasu","year":"2015","unstructured":"Inamasu JShizu NTsutsumi YHirose Y. Infected epidural hematoma of the lumbar spine associated with invasive pneumococcal disease. 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