Spinal epidural abscess: the importance of early diagnosis and treatment

J Neurol Neurosurg Psychiatry. 1998 Aug;65(2):209-12. doi: 10.1136/jnnp.65.2.209.

Abstract

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.

Publication types

  • Review

MeSH terms

  • Abscess / diagnosis*
  • Abscess / pathology
  • Abscess / surgery
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Combined Modality Therapy
  • Diagnosis, Differential
  • Epidural Space / pathology
  • Female
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Spinal Diseases / diagnosis*
  • Spinal Diseases / pathology
  • Spinal Diseases / surgery
  • Tomography, X-Ray Computed*

Substances

  • Anti-Bacterial Agents