Rare condition characterized by inflammation with pus within the epidural space.
Recognized risk factors include diabetes mellitus, intravenous drug abuse, history of recent spinal surgery or trauma, indwelling spinal catheter, concomitant local infection, and immunosuppression.
Cardinal features are back pain and fever, with the potential for development of neurologic deficit, but presentations vary.
Treatment includes intravenous antibiotics. Surgical decompression is indicated for patients with neurologic deficit.
Prognosis is most closely related to the patient's neurologic status at presentation.
A spinal epidural abscess (SEA) is inflammation with pus within the epidural space. The clinical presentation is insidious, and diagnosis is difficult in the early stages. Cardinal features are back pain and fever, with late neurologic deficit. SEA has a high morbidity and mortality if untreated.
History and exam
Kenneth F. Casey, MD
Associate Adjunct Professor
Clinical Associate Professor of Physical Medicine and Rehabilitation
Wayne State University School of Medicine
Clinical Associate Professor Surgery (Neurosurgery)
Michigan State University
KFC declares that he has no competing interests.
John M. Embil, MD, FRCPC
Section of Infectious Diseases
Department of Medicine
University of Manitoba
Infection Prevention and Control Unit Health Sciences Centre
JME declares that he has no competing interests.
Iain Christie, MB BhB, FRCA
IC declares that he has no competing interests.
Wendy Ziai, MD, MPH
Neurology, Neurosurgery, and Anesthesiology and Critical Care Medicine
The Johns Hopkins University
WZ declares that she has no competing interests.
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