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Spinal epidural abscess: the importance of early diagnosis and treatment
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  1. A R Mackenziea,
  2. R B S Lainga,
  3. C C Smitha,
  4. G F Kaarb,
  5. F W Smithc
  1. aThe Infection Unit, Aberdeen Royal Infirmary, Aberdeen, bDepartment of Neurosurgery, Aberdeen Royal Infirmary, Aberdeen, cDepartment of Radiology, Woodend Hospital, Aberdeen
  1. A R Mackenzie, The Infection Unit, Aberdeen Royal Infirmary, Aberdeen AB25 2ZN, UK. Telephone 0044 1224 681818; fax 0044 1224 685307.

Abstract

OBJECTIVES To remind clinicians of the dangers of delayed diagnosis and the importance of early treatment of spinal epidural abscess.

METHODS A review of the literature on spinal epidural abscess and a comparison of the published literature with local experience.

RESULTS Imaging with MRI or CT enables early diagnosis of spinal epidural abcess and optimal therapy is surgical evacuation combined with 6–12 weeks (median 8 weeks) of antimicrobial chemotherapy. Clinical features are fever, pain, and focal neurological signs and may be associated with preceding and pre-existing bone or joint disease. The commonest aetiological organism is S aureus.

CONCLUSION Early diagnosis and appropriate early antimicrobial chemotherapy with surgery is associated with an excellent prognosis.

  • spinal epidural abscess
  • diagnosis
  • treatment
  • magnetic resonance imaging

http://dx.doi.org/10.1136/jnnp.65.2.209

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      Journal of Neurology, Neurosurgery, and Psychiatry