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Spinal Epidural Abscess: Current Diagnosis and Management

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Abstract

Spinal epidural abscess (SEA) is an uncommon condition that warrants urgent diagnosis and treatment, because early pharmacotherapy significantly improves prognosis and prompt surgical decompression is often necessary to prevent or minimize neurologic complications. Increased awareness is critical; any of the characteristic clinical findings, especially in the presence of risk factors and elevated inflammatory markers, should lead to heightened suspicion for SEAs and its consideration on differential diagnosis, even in the absence of neurologic deficits. A multidisciplinary approach is essential for successful management of SEAs; along with infectious disease specialists and neurosurgeons/orthopedic spine surgeons, primary care, emergency medicine, and internal medicine clinicians are more likely to see patients with SEAs at earlier stages and play a pivotal role in early diagnosis and treatment. A combination of targeted antibiotic therapy and prompt surgical decompression is recommended in most cases, although medical management alone can be effective in select patients under close monitoring.

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Authors and Affiliations

  1. Department of Neurosurgery, The Johns Hopkins University School of Medicine, Phipps Building, Room 104, 600 North Wolfe Street, Baltimore, MD, 21287, USA

    Daniele Rigamonti

  2. Department of Neurosurgery, Johns Hopkins University School of Medicine, Meyer Building, Room 8-161, Baltimore, MD, 21287, USA

    Gustavo Pradilla

  3. Georgetown University School of Medicine, 3900 Reservoir Road NW, Medical Dental Building, Washington, DC, 20057, USA

    Yasunori Nagahama

  4. Infectious Diseases Clinical Fellow, BRB 871 Siliciano Laboratory, 733 North Broadway, Baltimore, MD, 21205, USA

    Adam M. Spivak

  5. Bayview Medical Center, Department of Neurosurgery, The Johns Hopkins University School of Medicine, Meyer Building, Room 5-109, 600 North Wolfe Street, Baltimore, MD, 21287, USA

    Ali Bydon

Authors
  1. Gustavo Pradilla
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  2. Yasunori Nagahama
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  3. Adam M. Spivak
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  4. Ali Bydon
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  5. Daniele Rigamonti
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Corresponding author

Correspondence to Daniele Rigamonti.

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Pradilla, G., Nagahama, Y., Spivak, A.M. et al. Spinal Epidural Abscess: Current Diagnosis and Management. Curr Infect Dis Rep 12, 484–491 (2010). https://doi.org/10.1007/s11908-010-0140-1

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  • DOI: https://doi.org/10.1007/s11908-010-0140-1

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