Cervical spinal epidural abscess: a rare but life-threatening infection of the spinal cord

A man in his late 50s was admitted with collapse and pneumonia on a background of poorly controlled diabetes. Following admission, the patient expressed concern regarding neurological symptoms he had been experiencing in the previous 2 weeks including incontinence of urine and faeces. These symptoms rapidly progressed to profound weakness in all limbs with significant reduction in his forced vital capacity. Emergency MRI showed a large cervical spinal epidural abscess for which he was admitted to the intensive care unit and transferred to a neurosurgical centre. He underwent emergency decompression with a prolonged course of antibiotics. After rehabilitation, the patient regained moderate function of his right arm and was transferred to a specialist spinal injury centre for ongoing care. Our case highlights the importance of high clinical suspicion and aggressive investigation and management in the case of patients with neurological symptoms in the context of infection with relevant risk factors.