Spinal Epidural Abscess Follow-up

  • Author: J Stephen Huff, MD; Chief Editor: Karen L Roos, MD   more...
 
Updated: May 7, 2012
 

Further Inpatient Care

  • Frequent neurologic assessment to detect any progression of neurologic deficit, particularly weakness, is required.
  • Postsurgical patients require monitoring of neurologic status as well.
  • If the patient has a deficit from spinal cord damage, nursing attention for skin care, catheter care, and physical therapy may be necessary.
Next

Further Outpatient Care

  • Rehabilitation for any residual neurologic deficit may be necessary. This would include restrengthening programs and ambulation retraining.
  • Home health care may help provide ongoing antibiotic and physical therapy.
Previous
Next

Transfer

Transfer to a facility with spinal cord imaging and appropriate surgical resources may be necessary.

Previous
Next

Complications

The many complications of spinal cord injury include bladder dysfunction, decubiti, supine hypertension, recurrent sepsis, and other problems.

Previous
Next

Prognosis

  • No studies have been done to assist in predicting prognosis.
  • Prognosis in general is related to the duration of spinal cord dysfunction and the degree of cord impairment at the time of diagnosis.
Previous
Next

Patient Education

For patient education resources, see the Infections Center and Brain and Nervous System Center, as well as Brain Infection and Antibiotics.

Previous
 
Contributor Information and Disclosures
Author

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

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

Disclosure: Nothing to disclose.

Specialty Editor Board

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, American Academy of Neurology, American Neurological Association, American Society for Biochemistry and Molecular Biology, Phi Beta Kappa, Sigma Xi, Society for Neuroscience, and Southern Clinical Neurological Society

Disclosure: Nothing to disclose.

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

Disclosure: Medscape Salary Employment

Florian P Thomas, MD, MA, PhD, Drmed  Director, Regional MS Center of Excellence, St Louis Veterans Affairs Medical Center; Director, National MS Society Multiple Sclerosis Center; Director, Neuropathy Association Center of Excellence, Professor, Department of Neurology and Psychiatry, Associate Professor, Institute for Molecular Virology, St Louis University School of Medicine

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

Disclosure: Nothing to disclose.

Chief Editor

Karen L Roos, MD  John and Nancy Nelson Professor of Neurology, Professor of Neurological Surgery, Department of Neurology, Indiana University School of Medicine

Karen L Roos, MD is a member of the following medical societies: American Academy of Neurology and American Neurological Association

Disclosure: Nothing to disclose.

References

  1. Darouiche RO. Spinal epidural abscess. N Engl J Med. Nov 9 2006;355(19):2012-20. [Medline].

  2. Bremer AA, Darouiche RO. Spinal epidural abscess presenting as intra-abdominal pathology: a case report and literature review. J Emerg Med. Jan 2004;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. Aug 1999;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. Nov 2009;65(5):919-23; discussion 923-4. [Medline].

  5. Joshi SM, Hatfield RH, Martin J, Taylor W. Spinal epidural abscess: a diagnostic challenge. Br J Neurosurg. Apr 2003;17(2):160-3. [Medline].

  6. Prendergast H, Jerrard D, O'Connell J. Atypical presentations of epidural abscess in intravenous drug abusers. Am J Emerg Med. Mar 1997;15(2):158-60. [Medline].

  7. 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. Apr 2004;26(3):285-91. [Medline].

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

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

  10. 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. Jul 31 2009;[Medline].

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

  12. 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. Jun 2011;14(6):765-70. [Medline].

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

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

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

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

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

  18. 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. Oct 30 2008;359(18):1942-9. [Medline].

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

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

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

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

  23. 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. Jun 30 2009;[Medline].

 
Previous
Next
 
Cervical epidural abscess with spinal cord compression and spinal cord edema.
Spinal epidural abscess lumbar area.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.