Epidural Abscess
What is an epidural abscess?
An epidural abscess is an infection that forms in the spinal canal around the spinal cord. It places the spinal cord at risk and can result in spinal cord injury and paralysis.
Early diagnosis is critical to treat the epidural abscess and its causes to avoid spinal cord injury. Patients who are immune-compromised or who have diabetes are more at risk for formation of an epidural abscess.
The leading symptom of a developing epidural abscess is back pain. It is my opinion that any patient with new onset severe back pain that is not explained by some other condition needs to have an MRI done urgently to rule out this condition.
Epidural Abscess and medical negligence
A case that I am currently working on involves a man who presented to the emergency room with new onset severe midthoracic back pain that radiated around his rib cage bilaterally to his chest. The cardiologist was called and he ruled out a cardiac source for the pain. A gastrointestinal doctor ruled out an abdominal source for the pain and a pulmonologist ruled out a thoracic cause for the pain. After three days, this diabetic man was sent home, with his back pain still present. Within 24 hours he was paraplegic from an epidural abscess that compressed his spinal cord. After emergency surgery, he did not improve.
Undiagnosed epidural abscess often occurs because of poor history taking where the “new onset” of the back pain and the developing increased severity of the pain is not appreciated. This is a condition that requires urgent attention and is usually requires a surgical drainage of the pus to decompress the spinal cord.