epidural abscess

clinical case of epidural abscess

Etiology-epidural abscess

Clinical manifestations-epidural abscess

• 背痛（約四分之三的患者）

• 發燒（幾乎一半的患者）

• 神經功能缺損（約三分之一的患者）

• The three most common symptoms of a spinal epidural abscess are back pain (about three-quarters of patients), fever (almost half of patients), and neurologic deficit (about one-third of patients).

• Back pain with spinal or paraspinal tenderness + fever ± followed by radiculopathy.

• Sx of cord compression or cauda equina is a surgical emergency.

• 對於發熱、白細胞增多和嚴重背痛的患者，最合適的檢查是 MRI，以評估疑似硬脊膜外膿腫。

Diagnostic studies

• MRI with contrast
• Aspiration of abscess fluid for Gram stain & cx or operative Gram stain & cx
• Blood cx (frequently ⊖)

Treatment-epidural abscess