Importance of early diagnosis and surgery in spinal epidural abscess

ABSTRACT

To remind clinicians of the possible consequences of delayed diagnosis of epidural abscess and the importance of early treatment. We report a case of one man who presented with epidural abscess localised in the dorsal spine which was seen on magnetic resonance imaging and revealed by spastic paraplegia and urine retention. Treatment consisted of laminectomy, abscess evacuation and antibiotic chemotherapy. The follow-up has been characterised by a good recovery after immediate surgery. Spinal epidural abscess is an uncommon disease [0.2 to 1.2/10,000 admissions]. The typical triad of back-pain, fever and motor deficitls has often been reported. Magnetic resonance imaging confirms the diagnosis in the majority of cases. The most common aetiological organism is staphylococcus aureus. The prognosis is poor, but early diagnosis and appropriate surgery with antimicrobial chemotherapy is associated with an excellent prognosis