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A case study of a 58-year old woman with fever and neck pain is discussed to better understand the causes and symptoms of spinal epidural abscess. The diagnosis and treatment suggested were also discussed.

Infection caused by the fungus Cryptococcus (C.) neoformans may result in a prostatic abscess. A prostatic abscess is the collection of pus within tissues of the prostate gland. A 55-year-old man was hospitalized because of a persistent urinary tract infection. He had painful urinations, urinary frequency and urinary hesitancy and he developed fatigue and nausea. He had a history of long-term use of suppressive therapy and was taking prednisone, cyclosporine, azathioprine, ampicillin, ranitidine, nicardipine, quinine sulfate and furosemide. On physical examination, his prostate was enlarged, irregular, slightly tender and draining pus. An ultrasonographic study of the prostate revealed a mass in the right lobe. Examination of prostate tissue removed during surgical resection of the gland showed severe inflammation and a blood sample showed evidence of C. neoformans infection. He improved greatly after the operation and with fluconazole therapy.

A 16-year-old boy from Bombay, India had suffered repeated seizures and was admitted to the hospital. A computed tomographic (CT) scan showed swelling and a mass in the left frontal region of the brain. The three most common conditions which could cause lesions in the brain of a child from India are tumor, tuberculoma (a tumor-like mass in the brain caused by Mycobacterium tuberculosis, which causes tuberculosis), and cysticercosis (caused by tape worms). The clinical features did not indicate diagnosis of a cerebral glioma, a type of tumor which occurs in children and causes seizures. It was thought that the mass was a tuberculoma as tuberculosis is endemic in Bombay and the clinical features were compatible with the diagnosis of tuberculoma without manifestations outside the brain. The patient had been vaccinated against tuberculosis in childhood, but vaccination is not an assurance that the disease will not develop later in life. However, the patient was given drugs for the treatment of tuberculosis and still had the seizures. Cysticercosis was still a possible diagnosis. Abscesses caused by infectious agents such as bacteria, fungi and protozoa, or parasites were also considered. A brain biopsy was performed and examination of the tissue revealed that the patient had cysticercosis, which was manifested as a granulomatous abscess in the brain. (Consumer Summary produced by Reliance Medical Information, Inc.)