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Spinal epidural abscess: the importance of early diagnosis and treatment
A R Mackenzie1, R B Laing, C C Smith
1The Infection Unit, Aberdeen Royal Infirmary, UK.
Objectives:
To remind clinicians of the dangers of delayed diagnosis and the importance of early treatment of spinal epidural abscess.
Methods:
A review of the literature on spinal epidural abscess and a comparison of the published literature with local experience.
Results:
Imaging with MRI or CT enables early diagnosis of spinal epidural abcess and optimal therapy is surgical evacuation combined with 6-12 weeks (median 8 weeks) of antimicrobial chemotherapy. Clinical features are fever, pain, and focal neurological signs and may be associated with preceding and pre-existing bone or joint disease. The commonest aetiological organism is S aureus.
Conclusion:
Early diagnosis and appropriate early antimicrobial chemotherapy with surgery is associated with an excellent prognosis.