Cervical Epidural Abscess Secondary to a Post-Traumatic Hematoma, Successfully Treated with Adjunctive Hyperbaric...

Background: Spinal epidural abscess (SEA) is a rare but challenging disease. Hyperbaric oxygen therapy (HBOT) is used as an adjunctive therapy for SEA in a limited number of hospitals; however, its efficacy has not been well described. Case: A 70-year-old man presented at our hospital with cervical pain, fever, and impaired right shoulder movement. The patient fell after drinking 17 days prior to the presentation. He was diagnosed with an SEA secondary to a spinal epidural hematoma caused by a prior injury. The patient also had dental caries, and his blood culture was positive for Streptococcus intermedius. We diagnosed the patient with a spinal epidural abscess and hematoma that developed from the caries and the injury. Antibiotics were initiated; however, the motor function gradually worsened, and decompressive surgery was performed. After surgery, neurological impairment persisted, and HBOT was used as an adjunctive therapy. After initiating HBOT, the patient's arm movements improved, and he was referred to a rehabilitation hospital on day 110 for further rehabilitation. Conclusions: HBOT is increasingly used for spinal cord infections and injuries in a limited number of institutions. It is a potentially effective adjunctive therapy for patients for whom antibiotics and surgery are ineffective.