title: Successful medical treatment of spinal epidural abscess.
abstract: Spinal epidural abscess is a rare but potentially fatal disease. A 67-year-old female suffered fever and painful swelling of the right knee and lower leg for one week. Both synovial fluid and blood cultures yielded methicillin-sensitive Staphylococcus aureus. Low back pain developed and fever was sustained despite the administration of intravenous oxacillin. Magnetic resonance imaging (MRI) of the thoracolumbar spine revealed spinal epidural abscess from T12 to S1. Because of severe hypoalbuminemia and general anasarca and followed by exploratory laparotomy for massive duodenal bleeding, she did not receive surgical intervention for the spinal epidural abscess. After intravenous administration of oxacillin 2 g 4-hourly for 12 weeks, she recovered and follow-up MRI confirmed the efficacy of the medical treatment. She remained well at 1-year follow-up. In a patient with minimal neurological deficit or surgical contraindication, spinal epidural abscess can be successfully treated with a medical regimen.
authors.affiliation: Division of Infectious Diseases and Topical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Number 325 Section 2 Cheng-Kung Road, Neihu, Taipei, Taiwan.
authors.forename: Bo-Ren
authors.initials: BR
authors.lastname: Xiao
authors.forename: Chih-Wei
authors.initials: CW
authors.lastname: Wang
authors.forename: Jung-Chung
authors.initials: JC
authors.lastname: Lin
authors.forename: Feng-Yee
authors.initials: FY
authors.lastname: Chang
mesh_terms: D000368:Aged; D020802:Epidural Abscess / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010068:Oxacillin / Q000008:administration & dosage; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000302:isolation & purification
chemical_list: D010068:Oxacillin