Epidural and Paraspinal Abscess Presenting as Acute Low Back Pain

J Orthop Sports Phys Ther. 2019 Jun;49(6):482. doi: 10.2519/jospt.2019.8456.

Abstract

A 56-year-old man sought care from a primary care physician (PCP) 5 days after lifting a heavy box produced acute, isolated lumbar pain. The PCP diagnosed a lumbar disc herniation and referred the patient to physical therapy without diagnostic imaging. Due to the presence of multiple red flags leading up to and during examination, the patient was transferred to the emergency department for further evaluation. Magnetic resonance imaging revealed a spinal epidural abscess with an associated multiloculated abscess within the adjacent left paraspinal muscles. J Orthop Sports Phys Ther 2019;49(6):482. doi:10.2519/jospt.2019.8456.

Keywords: abscess; low back pain; magnetic resonance imaging; spine.

Publication types

  • Case Reports

MeSH terms

  • Abscess / diagnostic imaging*
  • Abscess / drug therapy
  • Abscess / microbiology
  • Anti-Bacterial Agents / therapeutic use
  • Diagnosis, Differential
  • Humans
  • Low Back Pain / diagnostic imaging*
  • Low Back Pain / drug therapy
  • Low Back Pain / microbiology
  • Male
  • Middle Aged
  • Oxacillin / therapeutic use
  • Paraspinal Muscles / diagnostic imaging*
  • Paraspinal Muscles / drug effects
  • Paraspinal Muscles / microbiology
  • Rifampin / therapeutic use
  • Staphylococcal Infections / drug therapy
  • Staphylococcus aureus

Substances

  • Anti-Bacterial Agents
  • Oxacillin
  • Rifampin