Spinal epidural abscess--a case report

Despite modern medical advances, the morbidity and mortality rates associated with spinal epidural abscess remain significant, and the diagnosis is elusive. The incidence of spinal epidural abscess is approximately one to two cases per 10,000 among all patients admitted to hospitals. The symptoms of spinal epidural abscess are varied but include lower back pain, fever, local tenderness and neurological deficit especially in such high risk groups as patients with diabetes, intravenous drug abuse, chronic renal failure, alcoholism, liver disease and immunocompromization. Accumulation of data is difficult in that many physicians will never see a case during their careers. Herein, we present a case with lower back pain associated with both lower legs weakness. His abdomenon CT revealed retroperitonium and right perirenal abscess. External drainage as well as antibiotic treatment was done immediately. However, the lower legs weakness became severe and a lumbar spine MRI revealed T11-L4 epidural abscesses and L2-3 intervertebral space pus formation. Then, the patient was transfered to our Neurosurgical Ward for further treatment. His postoperative condition improved in both lower legs. This case report is to enhance the recognition and treatment of spinal epidural abscess, a rare affliction.