Two cases of spontaneous epidural abscess in patients with cirrhosis

Medical conditions predisposing to epidural abscess include diabetes, intravenous drug use, alcoholism, and other immunocompromised states. Although cirrhosis is associated with an increased risk of infection in general it has not previously been identified as a condition predisposing to epidural abscess. We describe two cirrhotic patients with spinal epidural abscesses. We speculate that the underlying immune defects associated with cirrhosis increase the risk of spontaneous epidural abscess and should raise concern for this infection when cirrhotic patients present with fever and back pain.