Epidural abscess - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Spinal epidural abscess is an uncommon condition characterized by inflammation with pus within the epidural space.
Potential risk factors include intravenous drug use, diabetes mellitus, recent spinal surgery or trauma, indwelling spinal catheter, contiguous local infection, concomitant bacteremia or endocarditis, chronic renal disease, and immunosuppression (e.g., HIV infection, malignancy). However, a significant proportion of patients do not have an obvious risk factor.
Classic features are back pain and fever, with the potential for development of neurologic deficit, but presentations vary.
Treatment includes intravenous antibiotics. Surgical decompression is required for patients with neurologic deficit.
Prognosis is most closely related to the patient's neurologic status at presentation.

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History & Exam
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Definition

Epidemiology

Etiology

Pathophysiology

Citations

Key Articles

Bond A, Manian FA. Spinal epidural abscess: a review with special emphasis on earlier diagnosis. Biomed Res Int. 2016 Dec 1 [Epub ahead of print].[Abstract][Full Text]
Sharfman ZT, Gelfand Y, Shah P, et al. Spinal epidural abscess: a review of presentation, management, and medicolegal implications. Asian Spine J. 2020 Oct;14(5):742-59.[Abstract][Full Text]
Sendi P, Bregenzer T, Zimmerli W. Spinal epidural abscess in clinical practice. QJM. 2008 Jan;101(1):1-12.[Abstract][Full Text]
Expert Panel on Neurological Imaging; Ortiz AO, Levitt A, Shah LM, et al. ACR Appropriateness Criteria® suspected spine infection. J Am Coll Radiol. 2021 Nov;18(suppl 11):S488-501.[Abstract][Full Text]
Suppiah S, Meng Y, Fehlings MG, et al. How best to manage the spinal epidural abscess? A current systematic review. World Neurosurg. 2016 Sep;93:20-8.[Abstract]
Evans L, Rhodes A, Alhazzani W, et al. Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock 2021. Crit Care Med. 2021 Nov 1;49(11):e1063-143.[Abstract][Full Text]

Referenced Articles

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