epidural abscess

Summary

Summary: Circumscribed collections of suppurative material occurring in the spinal or intracranial EPIDURAL SPACE. The majority of epidural abscesses occur in the spinal canal and are associated with OSTEOMYELITIS of a vertebral body; ANALGESIA, EPIDURAL; and other conditions. Clinical manifestations include local and radicular pain, weakness, sensory loss, URINARY INCONTINENCE, and FECAL INCONTINENCE. Cranial epidural abscesses are usually associated with OSTEOMYELITIS of a cranial bone, SINUSITIS, or OTITIS MEDIA. (From Adams et al., Principles of Neurology, 6th ed, p710 and pp1240-1; J Neurol Neurosurg Psychiatry 1998 Aug;65(2):209-12)

Top Publications

  1. Khan S, Hussain M, Griebel R, Hattingh S. Title comparison of primary and secondary spinal epidural abscesses: a retrospective analysis of 29 cases. Surg Neurol. 2003;59:28-33; discussion 33 pubmed
    ..In certain regions their incidence is rising. Vague initial presentation may result in delayed diagnosis. Familiarity with SEA is imperative because if not treated expeditiously, they can have devastating neurologic sequelae...
  2. Darouiche R. Spinal epidural abscess. N Engl J Med. 2006;355:2012-20 pubmed
  3. Henton J, Dabis H. Discitis and epidural abscess after dental extraction in a pediatric patient: a case report. Pediatr Emerg Care. 2009;25:862-4 pubmed publisher
    ..Neck pain is a relatively common pediatric complaint. Most is of benign etiology. We present an unusual case of epidural abscess with associated discitis in the cervical spine of a 12-year-old after a dental extraction...
  4. Song K, Yoon S, Lee K. Cervical spinal brucellosis with epidural abscess causing neurologic deficit with negative serologic tests. World Neurosurg. 2012;78:375.e15-9 pubmed publisher
    Here we present a case of cervical spinal epidural abscess causing neurologic deficits despite negative serologic tests.
  5. Zani D, Romano L, Scandella M, Rondena M, Riccaboni P, Morandi N, et al. Spinal epidural abscess in two calves. Vet Surg. 2008;37:801-8 pubmed publisher
    To report clinical signs, diagnostic and surgical or necropsy findings, and outcome in 2 calves with spinal epidural abscess (SEA).
  6. Zimmerer S, Conen A, Müller A, Sailer M, Taub E, Fluckiger U, et al. Spinal epidural abscess: aetiology, predisponent factors and clinical outcomes in a 4-year prospective study. Eur Spine J. 2011;20:2228-34 pubmed publisher
    Spinal epidural abscess (SEA) is a rare, but serious, condition with multiple causes...
  7. Chien J, Lin C, Chen Y, Lay C, Wang C, Tsai C. Epidural abscess caused by Haemophilus aphrophilus misidentified as Pasteurella species. Intern Med. 2009;48:853-8 pubmed
    ..A case of H. aphrophilus bacteremia complicated with epidural abscess, psoas muscle abscess, and spondylodiscitis is described in this report...
  8. Park M, Moon S, Hahn S, Lee H. Paraspinal abscess communicated with epidural abscess after extra-articular facet joint injection. Yonsei Med J. 2007;48:711-4 pubmed
    ..MRI) demonstrated the paraspinal abscess around the fourth and fifth spinous processes with an additional epidural abscess compressing the thecal sac. The facet joints were preserved...
  9. Hsieh M, Lu T, Ma M, Wang H, Chen S. Unrecognized cervical spinal epidural abscess associated with metastatic Klebsiella pneumoniae bacteremia and liver abscess in nondiabetic patients. Diagn Microbiol Infect Dis. 2009;65:65-8 pubmed publisher
    We describe a Klebsiella pneumoniae-related liver abscess and unrecognized epidural abscess with or without endophthalmitis in 2 nondiabetic patients, both of whom suffered neurologic complications after invasive procedure...

More Information

Publications68

  1. Turgut M. Complete recovery of acute paraplegia due to pyogenic thoracic spondylodiscitis with an epidural abscess. Acta Neurochir (Wien). 2008;150:381-6 pubmed publisher
    Pyogenic spondylodiscitis associated with epidural abscess is a rare but serious problem in spinal surgery, because it may cause a severe morbidity or mortality, if the diagnosis is established late and the treatment is inadequate...
  2. Huang P, Chen S, Chang W, Lu C, Chuang Y, Tsai N, et al. Spinal epidural abscess in adults caused by Staphylococcus aureus: clinical characteristics and prognostic factors. Clin Neurol Neurosurg. 2012;114:572-6 pubmed publisher
    Spinal epidural abscess (SEA) is a devastating infectious disease, which may result in neurologic sequelae. Staphylococcus (S.) aureus is a common pathogen of SEA...
  3. Ates O, Cayli S, Kocak A, Kutlu R, Onal R, Tekiner A. Spinal epidural abscess caused by brucellosis. Two case reports. Neurol Med Chir (Tokyo). 2005;45:66-70 pubmed
    ..Magnetic resonance imaging should be performed periodically in patients with brucellosis and suspected vertebral involvement to monitor for epidural granuloma formation and prevent extradural cord compression...
  4. Valero R, Castaneda O, de Francisco A, Piñera C, Rodrigo E, Arias M. [Clinical suspicion of vertebral osteomielitis: back pain in patients with hemodyalisis by catheter related infection]. Nefrologia. 2004;24:583-8 pubmed
    ..have been analysed, thereby we can conclude the most effective treatment of vertebral osteomyelitis and/or epidural abscess is premature diagnosis of these pathologies...
  5. Sengul G, Akar A, Alper F, Uslu H. Nonsurgically treated cervical brucellar epidural abscess causing spinal cord compression. J Clin Neurosci. 2008;15:1411-4 pubmed publisher
    Cervical spinal cord compression due to brucellar epidural abscess is extremely rare, with only 13 previously reported cases. We present another case of cervical spinal epidural abscess causing spinal cord compression...
  6. Patel D, Baron E, Enochs W, Ruth C, Harrop J, Vaccaro A. Spinal epidural abscess mimicking lymphoma: a case report. Orthopedics. 2008;31:402 pubmed
    ..Typical magnetic resonance imaging characteristics for epidural abscess are a heterogeneously enhancing epidural collection, which is isointense/hypointense on T1 images and ..
  7. Bostrom A, Oertel M, Ryang Y, Rohde V, Burgel U, Krings T, et al. Treatment strategies and outcome in patients with non-tuberculous spinal epidural abscess--a review of 46 cases. Minim Invasive Neurosurg. 2008;51:36-42 pubmed publisher
    Spinal epidural abscess (SEA) is a rare disease and its early detection and appropriate treatment is essential to prevent high morbidity and mortality...
  8. El Sayed M, Witting M. Low yield of ED magnetic resonance imaging for suspected epidural abscess. Am J Emerg Med. 2011;29:978-82 pubmed publisher
    The aim of this study was to estimate the yield of emergency department (ED) magnetic resonance imaging (MRI) in detecting spinal epidural abscess (SEA) and to identify clinical factors predicting positive MRI results.
  9. Safavi Abbasi S, Maurer A, Rabb C. Minimally invasive treatment of multilevel spinal epidural abscess. J Neurosurg Spine. 2013;18:32-5 pubmed publisher
    The use of minimally invasive tubular retractor microsurgery for treatment of multilevel spinal epidural abscess is described. This technique was used in 3 cases, and excellent results were achieved...
  10. Kohshi K, Abe H, Mizoguchi Y, Shimokobe M. Successful treatment of cervical spinal epidural abscess by combined hyperbaric oxygenation. Mt Sinai J Med. 2005;72:381-4 pubmed
    A 49-year-old man underwent hyperbaric oxygen (HBO) therapy for the treatment of primary spinal epidural abscess. Although the epidural abscess was initially treated with antibiotic (cefozopran) for 5 days, he subsequently developed motor ..
  11. Metta H, Corti M, Brunzini R. Disseminated infection due to Mycobacterium chelonae with scleritis, spondylodiscitis and spinal epidural abscess. Braz J Infect Dis. 2008;12:260-2 pubmed
    ..a case of a disseminated infection due to Mycobacterium chelonae with scleritis, spondylodiscitis and spinal epidural abscess in a man with a medical background of cellular immunity deficit induced by therapeutic drugs...
  12. Rust T, Kohan S, Steel T, Lonergan R. CT guided aspiration of a cervical spinal epidural abscess. J Clin Neurosci. 2005;12:453-6 pubmed
    The management of spinal epidural abscess has changed over the last few years. Originally treatment was thought to be urgent surgical evacuation. In the more recent literature less invasive techniques have been suggested...
  13. Fang W, Chen S, Huang D, Huang K. Post-traumatic osteomyelitis with spinal epidural abscess of cervical spine in a young man with no predisposing factor. J Chin Med Assoc. 2009;72:210-3 pubmed publisher
    Spinal osteomyelitis with epidural abscess is a rare disease...
  14. Daglioglu E, Bayazit N, Okay O, Dalgic A, Hatipoglu H, Ergungor F. Lumbar epidural abscess caused by brucella species: report of two cases. Neurocirugia (Astur). 2009;20:159-62 pubmed
    Spinal epidural abscess due to Brucella species is usually associated with spondylodiscitis. Urgent surgical decompression should be performed in cases with moderate to severe neurological deficits particularly if progressive...
  15. Aleksic Shihabi A, Dubravica I, Celić S, Bilić B, Knezević V. Our experience in the diagnosis of spinal epidural abscess with the use of new diagnostic methods--computed tomography and magnetic resonance imaging. Acta Clin Croat. 2009;48:167-70 pubmed
    ..Microbiology confirmed Staphylococcus aureus in the intraoperative tissue specimen. The patient was discharged from the hospital with mild paraparesis and continuing antibiotic therapy recommended...
  16. Pasqualini L, Mencacci A, Scarponi A, Leli C, Fabbriciani G, Callarelli L, et al. Cervical spondylodiscitis with spinal epidural abscess caused by Aggregatibacter aphrophilus. J Med Microbiol. 2008;57:652-5 pubmed publisher
    ..We report a case of cervical spondylodiscitis complicated by spinal epidural abscess in a 63-year-old woman, without underlying predisposing conditions...
  17. Tew C, Han F, Jureen R, Tey B. Aspergillus vertebral osteomyelitis and epidural abscess. Singapore Med J. 2009;50:e151-4 pubmed
    We present the first reported case of Aspergillus vertebral osteomyelitis and epidural abscess in Singapore in a 50-year-old man with post-tuberculous bronchiectasis...
  18. Carragoso A, Capelo J. [Spinal epidural abscess due to group C Streptococcus]. Acta Reumatol Port. 2007;32:287-97 pubmed
    Spinal epidural abscess is a rare clinical entity, presenting insidiously with nonspecific clinical manifestations. The diagnosis is usually difficult and, if not made early, the consequences may be disastrous...
  19. Oktenoglu T, Sasani M, Cetin B, Bozkus H, Ercelen O, Vural M, et al. Spontaneous pyogenic spinal epidural abscess. Turk Neurosurg. 2011;21:74-82 pubmed
    Spontaneous pyogenic spinal epidural abscess (SEA) is a rare condition but might be devastating and fatal. Traditional treatment is surgical decompression and antibiotics...
  20. Chan Y, Dasey N. Iatrogenic spinal epidural abscess. Acta Chir Belg. 2007;107:109-18 pubmed
    Iatrogenic epidural abscess complicating neuro-axial blockade is rare, but carries significant morbidity and mortality if diagnosis is delayed...
  21. Chen S, Chang W, Lu C, Chuang Y, Lui C, Chen S, et al. The clinical characteristics, therapeutic outcome, and prognostic factors of non-tuberculous bacterial spinal epidural abscess in adults: a hospital-based study. Acta Neurol Taiwan. 2011;20:107-13 pubmed
    Nontuberculous bacterial spinal epidural abscess (SEA) is a serious infectious disease of spines. Despite proper management, SEA remains a disease of high morbidity. The epidemiological data in southern Taiwan is still lacking.
  22. Felício J, Martins C, Liberman B. Diabetes mellitus and spinal epidural abscess: clinical or surgical treatment?. Arq Bras Endocrinol Metabol. 2011;55:720-2 pubmed
    Spinal epidural abscess (SEA) is an uncommon condition and its most important predisposing factor is diabetes mellitus...
  23. Muzii V, Mariottini A, Zalaffi A, Carangelo B, Palma L. Cervical spine epidural abscess: experience with microsurgical treatment in eight cases. J Neurosurg Spine. 2006;5:392-7 pubmed
    ..The authors report a series of eight consecutive cases in which epidural abscesses in the cervical spine were treated by microsurgery without arthrodesis, including two cases of concomitant pyogenic and tubercular infection...
  24. Savage K, Holtom P, Zalavras C. Spinal epidural abscess: early clinical outcome in patients treated medically. Clin Orthop Relat Res. 2005;439:56-60 pubmed
    Treatment of spinal epidural abscess has been based on surgical debridement. Medical treatment with antibiotics has been proposed as an alternative, but data on its efficacy are limited...
  25. Izci Y. Lumbosacral spinal epidural abscess caused by Brucella melitensis. Acta Neurochir (Wien). 2005;147:1207-9; discussion 1209 pubmed
    Spinal epidural abscess is a rare condition that can lead to irreversible complications and death if untreated. Rarely, Brucella melitensis may produce spondylodiscitis, which may be complicated by spinal epidural abscess...
  26. Curry W, Hoh B, Amin Hanjani S, Eskandar E. Spinal epidural abscess: clinical presentation, management, and outcome. Surg Neurol. 2005;63:364-71; discussion 371 pubmed
    We sought to describe the clinical characteristics of patients with spinal epidural abscess and to relate presentation and treatment to short-term clinical and neurologic outcome.
  27. Ptaszynski A, Hooten W, Huntoon M. The incidence of spontaneous epidural abscess in Olmsted County from 1990 through 2000: a rare cause of spinal pain. Pain Med. 2007;8:338-43 pubmed
    The primary objective of this study is to determine the population-based incidence of spontaneous epidural abscess. The secondary objective is to characterize the clinical course of patients with this rare infectious disease.
  28. West K, Mason R, Sun M. Nocardia spinal epidural abscess: 14-year follow-up. Orthopedics. 2012;35:e128-31 pubmed publisher
    ..On admission, magnetic resonance imaging (MRI) revealed an epidural abscess. The patient underwent irrigation and debridement...
  29. Karikari I, Powers C, Reynolds R, Mehta A, Isaacs R. Management of a spontaneous spinal epidural abscess: a single-center 10-year experience. Neurosurgery. 2009;65:919-23; discussion 923-4 pubmed publisher
    ..debate in the literature regarding the optimal management of patients with the diagnosis of a spinal epidural abscess (SEA)...
  30. Choma T, Burke M, Kim C, Kakarlapudi R. Epidural abscess as a delayed complication of spinal instrumentation in scoliosis surgery: a case of progressive neurologic dysfunction with complete recovery. Spine (Phila Pa 1976). 2008;33:E76-80 pubmed publisher
    A case report of late-onset paraplegia from an epidural abscess in a patient years after her instrumentation and fusion for scoliosis.
  31. Pradilla G, Ardila G, Hsu W, Rigamonti D. Epidural abscesses of the CNS. Lancet Neurol. 2009;8:292-300 pubmed publisher
    ..Increased clinical awareness can greatly improve outcomes by helping to diagnose patients earlier...
  32. Lampen R, Bearman G. Epidural abscess caused by Streptococcus milleri in a pregnant woman. BMC Infect Dis. 2005;5:100 pubmed
    ..Albeit rare, S. milleri spinal-epidural abscess in pregnancy has been reported, always as a complication of spinal-epidural anesthesia...
  33. Smith C, Kavar B. Extensive spinal epidural abscess as a complication of Crohn's disease. J Clin Neurosci. 2010;17:144-6 pubmed publisher
    A spinal epidural abscess is a neurosurgical emergency. Successful treatment frequently requires decompression of the spinal canal in combination with intravenous antibiotics...
  34. Sendi P, Bregenzer T, Zimmerli W. Spinal epidural abscess in clinical practice. QJM. 2008;101:1-12 pubmed
    Spinal epidural abscess (SEA) is a rare but severe infection requiring prompt recognition. The major prognostic factor for a favourable outcome is early diagnosis, leading to appropriate treatment...
  35. Bruns A, Sood N. Community-acquired methicillin-resistant Staphylococcus aureus epidural abscess with bacteremia and multiple lung abscesses: case report. Am J Crit Care. 2009;18:88, 86-7 pubmed publisher
    ..Blood cultures eventually became negative for the staphylococci, and the patient was discharged to a rehabilitation facility. A probable source of the infection was the patient's self-cutting and self-piercing...
  36. Marson F, Cognard C, Guillem P, Sevely A, Manelfe C. [Septic arthritis of a lumbar facet joint associated with epidural and paravertebral soft tissue abscess]. J Radiol. 2001;82:63-6 pubmed
    ..of the lumbar facet joint is rare, probably underdiagnosed, often associated with complications such as epidural abscess and paraspinal muscles abscess. Diagnosis is based on imaging evaluation...
  37. Alcock E, Regaard A, Browne J. Facet joint injection: a rare form cause of epidural abscess formation. Pain. 2003;103:209-10 pubmed
    ..b>Epidural abscess is a rare but potentially very serious occurrence...
  38. Carmouche J, Molinari R. Epidural abscess and discitis complicating instrumented posterior lumbar interbody fusion: a case report. Spine (Phila Pa 1976). 2004;29:E542-6 pubmed
    A case of epidural abscess and discitis following instrumented PLIF using a single carbon fiber interbody cage is presented.
  39. Hooten W, Kinney M, Huntoon M. Epidural abscess and meningitis after epidural corticosteroid injection. Mayo Clin Proc. 2004;79:682-6 pubmed
    b>Epidural abscess with and without associated meningitis after epidural corticosteroid injections for radicular back pain is a rarely reported complication...
  40. Lu C, Chang W, Lui C, Lee P, Chang H. Adult spinal epidural abscess: clinical features and prognostic factors. Clin Neurol Neurosurg. 2002;104:306-10 pubmed
    Twenty-nine adult patients with spinal epidural abscess (SEA), aged 31-73 years, have been identified over a period of 8 years. The 29 SEA patients included 21 men and eight women with a mean age of 54 years...
  41. Moonis G, Granados A, Simon S. Epidural hematoma as a complication of sphenoid sinusitis and epidural abscess: a case report and literature review. Clin Imaging. 2002;26:382-5 pubmed
    Imaging is of paramount importance in early diagnosis of epidural abscess and its intracranial complications. Typical CT imaging features of an epidural abscess include a hypodense lentiform extra-axial collection with rim enhancement...
  42. Buyukbebeci O, Karakurum G, Gulec A, Erbagci A. Tuberculous osteomyelitis of the lumbosacral region: a spinal epidural abscess with presacral extension. Arch Orthop Trauma Surg. 2004;124:346-8 pubmed
    ..We present the outcome of a patient who had an epidural abscess with presacral extension.
  43. Pina M, Modrego P, Uroz J, Cobeta J, Lerin F, Baiges J. Brucellar spinal epidural abscess of cervical location: report of four cases. Eur Neurol. 2001;45:249-53 pubmed
    ..The purpose of this article is to analyse 4 cases of brucellar spinal epidural abscess of cervical location and diagnosed in the Province of Teruel, Spain, an endemic area for the disease, through ..
  44. Muffoletto A, Ketonen L, Mader J, Crow W, Hadjipavlou A. Hematogenous pyogenic facet joint infection. Spine (Phila Pa 1976). 2001;26:1570-6 pubmed
    ..Retrospective...
  45. Chandy B, Todd J, Stucker F, Nathan C. Pott's puffy tumor and epidural abscess arising from dental sepsis: a case report. Laryngoscope. 2001;111:1732-4 pubmed
    To present an unusual case of two uncommon cranial complications of frontal sinusitis: Pott's puffy tumor and epidural abscess arising from frontal sinusitis of dental origin, and also two systemic complications of sinusitis: septicemia ..
  46. Chao D, Nanda A. Spinal epidural abscess: a diagnostic challenge. Am Fam Physician. 2002;65:1341-6 pubmed
    b>Epidural abscess of the spinal column is a rare condition that can be fatal if left untreated...
  47. Parkinson J, Sekhon L. Spinal epidural abscess: appearance on magnetic resonance imaging as a guide to surgical management. Report of five cases. Neurosurg Focus. 2004;17:E12 pubmed
    Spinal epidural abscess is associated with considerable rates of morbidity and mortality despite its infrequent occurrence...
  48. Nejat F, Ardakani S, Khotaei G, Roodsari N. Spinal epidural abscess in a neonate. Pediatr Infect Dis J. 2002;21:797-8 pubmed
    A case of purulent spinal epidural abscess in a 20-day-old girl is presented. The patient had symptoms of fever, localized back pain and swelling over the interscapular area. The diagnosis was made by magnetic resonance imaging...
  49. Diaz J. Chronic postoperative epidural abscess with ascending neuromyotonia. Anesth Analg. 2002;95:1770-1, table of contents pubmed
  50. Hernandez J, Coyle F, Wright C, Ballantyne J. Epidural abscess after epidural anesthesia and continuous epidural analgesia in a patient with gastric lymphoma. J Clin Anesth. 2003;15:48-51 pubmed
    A case of spinal epidural abscess, a rare but possibly devastating complication of epidural instrumentation and catheterization, is described in an immunocompromised patient, which presented atypically and which resulted in the patient's ..
  51. Lohr M, Reithmeier T, Ernestus R, Ebel H, Klug N. Spinal epidural abscess: prognostic factors and comparison of different surgical treatment strategies. Acta Neurochir (Wien). 2005;147:159-66; discussion 166 pubmed
    Spinal epidural abscess (SEA) is a rare but potentially devastating disease requiring immediate surgical intervention and appropriate antibiotic treatment. The standard approach to decompress SEA is laminectomy...
  52. Lyu R, Chen C, Tang L, Chen S. Spinal epidural abscess successfully treated with percutaneous, computed tomography-guided, needle aspiration and parenteral antibiotic therapy: case report and review of the literature. Neurosurgery. 2002;51:509-12; discussion 512 pubmed
    We describe a case of a posterior spinal epidural abscess that was successfully treated with percutaneous, computed tomography-guided, needle aspiration and parenteral antibiotic therapy.
  53. Lakshmi V, Sundaram C, Meena A, Murthy J. Primary cutaneous nocardiosis with epidural abscess caused by Nocardia brasiliensis: a case report. Neurol India. 2002;50:90-2 pubmed
    ..MRI showed an epidural abscess compressing the cord. Histopathology of skin lesions suggested a chronic suppurative lesion...
  54. Schultz K, Comey C, Haid R. Technical note. Pyogenic spinal epidural abscess: a minimally invasive technique for multisegmental decompression. J Spinal Disord. 2001;14:546-9 pubmed
    Spontaneous spinal epidural abscess is a rare condition that is devastating and often fatal. Traditionally, surgery and antibiotics have been the treatment of choice; however, there has been some debate on the indications for their use...
  55. Liang J, Fang C, Chen Y, Chang S, Luh K. Candida albicans spinal epidural abscess secondary to prosthetic valve endocarditis. Diagn Microbiol Infect Dis. 2001;40:121-3 pubmed
    ..Magnetic resonance imaging detected an L5-S1 spinal epidural abscess. A vegetation on prosthetic mitral valve was found by transesophageal echocardiography...
  56. Mann S, Schütze M, Sola S, Piek J. Nonspecific pyogenic spondylodiscitis: clinical manifestations, surgical treatment, and outcome in 24 patients. Neurosurg Focus. 2004;17:E3 pubmed
    ..The aim of the current study was to evaluate the strategy of a primary surgical approach to this disease...
  57. Muffolerro A, Nader R, Westmark R, Nauta H, Garges K, Hadjipavlou A. Hematogenous pyogenic facet joint infection of the subaxial cervical spine. A report of two cases and review of the literature. J Neurosurg. 2001;95:135-8 pubmed
    ..Approximately one fourth of facet joint infections in the lumbar spine are complicated by epidural abscess formation, which can lead to a neurological deficit...
  58. Chi C, Fung C, Liu C. Aspergillus flavus epidural abscess and osteomyelitis in a diabetic patient. J Microbiol Immunol Infect. 2003;36:145-8 pubmed
    ..pain accompanied with peripheral neuropathy in diabetic patients should raise the suspicion of Aspergillus epidural abscess. Prompt aggressive diagnostic testing and management is needed to improve the likelihood of a good outcome of ..
  59. Rotstein A, Stuckey S. Mycobacterium avium complex spinal epidural abscess in an HIV patient. Australas Radiol. 1999;43:554-7 pubmed
    ..A case of MAC spinal epidural abscess without vertebral osteomyelitis, that was continuous with presacral and bilateral piriformis muscle ..