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Multifocal metachronous epidural abscesses of the spine. A case report
G H Chow1, J S Gebhard, C W Brown
1Lakewood Orthopaedic Clinic, CO 80215, USA.
Study Design:
A retrospective case report of a patient who had a lumbar epidural abscess treated surgically who then developed a cervical epidural abscess that also required surgical treatment.
Objectives:
To describe a patient in whom treatment of a single epidural abscess with surgery and antibiotics was not sufficient to eradicate the systemic infection.
Summary Of Background Data:
Epidural abscesses are most commonly seen after invasive procedures that violate the epidural space. Epidural abscesses are usually a solitary event occurring in only one location and are usually treatable with surgical drainage and parenteral antibiotics.
Methods:
An elderly patient presented with neck and shoulder pain and fever. Evaluation revealed degenerative disease of the cervical spine. Within a week, she developed a cauda equina syndrome secondary to a lumber epidural abscess. The abscess was drained and intravenous antibiotics were given. Seventeen days later, while still receiving antibiotics, she developed a cervical epidural abscess which also required surgical drainage.
Results:
The patient showed gradual improvement in her neurologic status. No recurrence of either epidural abscess was observed.
Conclusions:
An epidural abscess may represent a serious systemic infection that requires aggressive treatment. Close follow-up is necessary to ensure that the infection has been eradicated and that no recurrent abscess has formed in the same or a different location. Aggressive antibiotic treatment is also strongly recommended.