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Spinal Epidural Abscess Differential Diagnoses

  • Author: J Stephen Huff, MD, FACEP; Chief Editor: Niranjan N Singh, MD, DM  more...
 
Updated: Jun 14, 2016
 
 

Diagnostic Considerations

Cervical disk syndromes

Lumbosacral disk syndromes

Lumbosacral spondylosis

Diabetes mellitus

Intravenous drug use

Psoas abscess

Retropharyngeal abscess

Transverse myelitis

Urinary tract infection

Vertebral osteomyelitis

Back pain

Cat scratch disease[11]

Differential Diagnoses

 
 
Contributor Information and Disclosures
Author

J Stephen Huff, MD, FACEP Professor of Emergency Medicine and Neurology, Department of Emergency Medicine, University of Virginia School of Medicine

J Stephen Huff, MD, FACEP is a member of the following medical societies: American Academy of Neurology, American College of Emergency Physicians, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Florian P Thomas, MD, PhD, Drmed, MA, MS Director, National MS Society Multiple Sclerosis Center; Professor and Director, Clinical Research Unit, Department of Neurology, Adjunct Professor of Physical Therapy, Associate Professor, Institute for Molecular Virology, St Louis University School of Medicine; Editor-in-Chief, Journal of Spinal Cord Medicine

Florian P Thomas, MD, PhD, Drmed, MA, MS is a member of the following medical societies: Academy of Spinal Cord Injury Professionals, American Academy of Neurology, American Neurological Association, Consortium of Multiple Sclerosis Centers, National Multiple Sclerosis Society, Sigma Xi

Disclosure: Nothing to disclose.

Chief Editor

Niranjan N Singh, MD, DM Associate Professor of Neurology, University of Missouri-Columbia School of Medicine

Niranjan N Singh, MD, DM is a member of the following medical societies: American Academy of Neurology, American Association of Neuromuscular and Electrodiagnostic Medicine, American Headache Society

Disclosure: Nothing to disclose.

Additional Contributors

Edward L Hogan, MD Professor, Department of Neurology, Medical College of Georgia; Emeritus Professor and Chair, Department of Neurology, Medical University of South Carolina

Edward L Hogan, MD is a member of the following medical societies: Alpha Omega Alpha, Society for Neuroscience, American Society for Biochemistry and Molecular Biology, American Academy of Neurology, American Neurological Association, Phi Beta Kappa, Sigma Xi, Southern Clinical Neurological Society

Disclosure: Nothing to disclose.

References
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  2. Bremer AA, Darouiche RO. Spinal epidural abscess presenting as intra-abdominal pathology: a case report and literature review. J Emerg Med. 2004 Jan. 26(1):51-6. [Medline].

  3. Rigamonti D, Liem L, Sampath P, et al. Spinal epidural abscess: contemporary trends in etiology, evaluation, and management. Surg Neurol. 1999 Aug. 52(2):189-96; discussion 197. [Medline].

  4. Karikari IO, Powers CJ, Reynolds RM, Mehta AI, Isaacs RE. Management of a spontaneous spinal epidural abscess: a single-center 10-year experience. Neurosurgery. 2009 Nov. 65(5):919-23; discussion 923-4. [Medline].

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  8. Davis DP, Wold RM, Patel RJ, et al. The clinical presentation and impact of diagnostic delays on emergency department patients with spinal epidural abscess. J Emerg Med. 2004 Apr. 26(3):285-91. [Medline].

  9. Trombly R, Guest JD. Acute central cord syndrome arising from a cervical epidural abscess: case report. Neurosurgery. 2007 Aug. 61(2):E424-5; discussion E425. [Medline].

  10. Dugas AF, Lucas JM, Edlow JA. Diagnosis of spinal cord compression in nontrauma patients in the emergency department. Acad Emerg Med. 2011 Jul. 18(7):719-25. [Medline].

  11. Tasher D, Armarnik E, Mizrahi A, Liat BS, Constantini S, Grisaru-Soen G. Cat Scratch Disease With Cervical Vertebral Osteomyelitis and Spinal Epidural Abscess. Pediatr Infect Dis J. 2009 Jul 31. [Medline].

  12. Mehta SH, Shih R. Cervical epidural abscess associated with massively elevated erythrocyte sedimentation rate. J Emerg Med. 2004 Jan. 26(1):107-9. [Medline].

  13. Davis DP, Salazar A, Chan TC, Vilke GM. Prospective evaluation of a clinical decision guideline to diagnose spinal epidural abscess in patients who present to the emergency department with spine pain. J Neurosurg Spine. 2011 Jun. 14(6):765-70. [Medline].

  14. Siddiq F, Chowfin A, Tight R, et al. Medical vs surgical management of spinal epidural abscess. Arch Intern Med. 2004 Dec 13-27. 164(22):2409-12. [Medline].

  15. Pradilla G, Ardila GP, Hsu W, Rigamonti D. Epidural abscesses of the CNS. Lancet Neurol. 2009 Mar. 8(3):292-300. [Medline].

  16. Hawkins M, Bolton M. Pediatric spinal epidural abscess: a 9-year institutional review and review of the literature. Pediatrics. 2013 Dec. 132(6):e1680-5. [Medline].

  17. Pereira CE, Lynch JC. Spinal epidural abscess: an analysis of 24 cases. Surg Neurol. 2005. 63 Suppl 1:S26-9. [Medline].

  18. Patel AR, Alton TB, Bransford RJ, Lee MJ, Bellabarba CB, Chapman JR. Spinal epidural abscesses: risk factors, medical versus surgical management, a retrospective review of 128 cases. Spine J. 2014 Feb 1. 14(2):326-30. [Medline].

  19. Bluman EM, Palumbo MA, Lucas PR. Spinal epidural abscess in adults. J Am Acad Orthop Surg. 2004 May-Jun. 12(3):155-63. [Medline].

  20. Butler KH. Spinal epidural abscess: Current diagnostic and management protocols. Emerg Med Rep. 21:95-104.

  21. Gerberding JL, Romero JM, Ferraro MJ. Case records of the Massachusetts General Hospital. Case 34-2008. A 58-year-old woman with neck pain and fever. N Engl J Med. 2008 Oct 30. 359(18):1942-9. [Medline].

  22. Grewal S, Hocking G, Wildsmith JA. Epidural abscesses. Br J Anaesth. 2006 Mar. 96(3):292-302. [Medline].

  23. Hooten WM, Kinney MO, Huntoon MA. Epidural abscess and meningitis after epidural corticosteroid injection. Mayo Clin Proc. 2004 May. 79(5):682-6. [Medline].

  24. Tessman PA, Preston DC, Shapiro BE. Spinal epidural abscess in an afebrile patient. Arch Neurol. 2004 Apr. 61(4):590-1. [Medline].

  25. Tompkins M, Panuncialman I, Lucas P, Palumbo M. Spinal epidural abscess. J Emerg Med. 2010 Sep. 39(3):384-90. [Medline].

  26. Uchida K, Nakajima H, Yayama T, Sato R, Kobayashi S, Chen KB, et al. Epidural abscess associated with pyogenic spondylodiscitis of the lumbar spine; evaluation of a new MRI staging classification and imaging findings as indicators of surgical management: a retrospective study of 37 patients. Arch Orthop Trauma Surg. 2009 Jun 30. [Medline].

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Cervical epidural abscess with spinal cord compression and spinal cord edema.
Spinal epidural abscess lumbar area.
 
 
 
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