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CASE REPORT
Spinal cord compression secondary to epidural abscess: the importance of prompt diagnosis and management
  1. Chloe Thomson
  1. Acute Medicine, William Harvey Hospital, Ashford, UK
  1. Correspondence to Dr Chloe Thomson, chloe.thomson{at}doctors.org.uk, chloe_thomson{at}hotmail.co.uk

Summary

A 66-year-old woman presented with a 4-day history of fever, lethargy, neck and lower back pain. Neurological examination revealed mild quadraparesis. In view of this, MRI whole spine with contrast was performed and showed extensive spinal epidural abscess extending from the cervical to lumbar region causing compression of the thecal sac, spinal cord and nerves. The patient received multiple laminectomies to decompress the spinal cord and required a prolonged course of intravenous flucloxacillin as Staphylococcus aureus was cultured from three sets of blood cultures. Although spinal epidural abscess is rare, it is important for clinicians to have a high index of suspicion; so appropriate imaging is performed to determine the diagnosis. Patient age, degree of thecal sac compression and duration of symptoms are all independently associated with poor outcome.1

  • infection (neurology)
  • neuroimaging
  • neurological injury
  • spinal cord

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Footnotes

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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