Abscess – epidural; Spinal abscess
Causes, incidence, and risk factors
Epidural abscess is a rare disorder caused by infection in the area between the bones of the skull or spine, and the membranes covering the brain and spinal cord (meninges). This infection is called an intracranial epidural abscess if it is inside the skull area, or a spinal epidural abscess if it is found in the spine area. Most are located in the spine.
The spinal infection is usually caused by bacteria (Staphylococcus aureus is most common), but may be caused by fungus. It can be due to other infections in the body (especially a urinary tract infection), or germs that spread through the blood. However, in some patients, no other source of infection is found.
An intracranial epidural abscess (within the skull). Risk factors include:
Chronic ear infections
A spinal epidural abscess may be seen in patients with:
A history of back surgery or other invasive procedures involving the spine
Boilsespecially on the back or scalp
Bone infections of the spine (vertebral osteomyelitis)
People who inject drugs are also at increased risk.
Spinal epidural abscess:
Bowelor bladder incontinence
- Difficulty urinating (urinary retention)
- Fever and back pain
Intracranial epidural abscess:
- Nausea and vomiting
- Pain at the site of recent surgery that gets worse (especially if fever is present)
Neurological symptoms depend on the location of the abscess and may include:
- Decreased ability to move any part of the body
Loss of sensationin any area of the body, or abnormal changes in sensation
Signs and tests
The health care provider will perform an exam to look for a loss of functions such as movement or sensation.
Tests may include:
- Blood cultures
- Complete blood count (CBC)
CTscan of head or spine
Draining of abscess and examination of the material
MRIof head or spine
The goal of treatment is to cure the infection and reduce the risk of permanent damage. Treatment usually includes antibiotics and surgery. In rare cases, antibiotics alone are used.
Antibiotics are usually given through a vein (IV) for at least 4 – 6 weeks. However, some people may need to take them for a longer time, depending on the type of bacteria and severity of the disease.
Surgery is usually needed to drain or remove the abscess. In addition, surgery is often needed to reduce pressure on the spinal cord or brain, to prevent further loss of function.
Early diagnosis and treatment greatly improve the chance of a good outcome. Once weakness,
- Brain damage
- Bone infection (osteomyelitis)
- Chronic back pain
- Nerve damage
- Return of infection
Spinal cord abscess
Calling your health care provider
Call your health care provider if you have:
Persistent back pain with fever
Headache with fever
Other symptoms of epidural abscess
An epidural abscess is a medical emergency.
Treatment of certain infections, such as