Spinal Epidural Abscess - Illness Script Epidemiology: - Patients at risk for bacteremia: IVDU, dental abscess, HD catheter, endocarditis, epidural catheter placement - Other risk factors: Alcoholism, DM, HIV Microbiology: - Staph aureus most common (63%) Clinical features: - Classic, but rare triad: Fever, spinal pain, neuro deficits - Classic progression: Focal severe back pain -5 radiculopathy motor weakness, sensory changes, and bladder/ bowel dysfunction paralysis Diagnosis: - MRI with contrast - Locate the source: blood cultures (positive 62%), thorough H&P, other imaging as needed Treatment: - Surgical drainage - Antibiotics Prognosis: - 5% mortality - Significant numbers have residual neurological deficits including paraplegia SCVMC Internal Medicine @SCVMCMed #Spinal #Epidural #Abscess #diagnosis #management
