Spontaneous methicillin-resistant Staphylococcus aureus epidural abscess in pregnancy.
BACKGROUND
Epidural abscess is a rare complication of regional anesthesia, and spontaneous formation is even more uncommon. Diabetes mellitus, concomitant infection, intravenous drug use, and immune suppression are risk factors for spontaneous epidural abscess.


METHODS
A 29-year-old white woman presented at 28 weeks of estimated gestational age reporting an intermittent headache. She had Horner syndrome and was hospitalized. A cervicothoracic epidural abscess was diagnosed. Surgical decompression and parenteral antibiotics resulted in complete resolution of neurologic symptoms. Cultures were positive for methicillin-resistant Staphylococcus aureous.


CONCLUSIONS
Spontaneous epidural abscess is a rare condition and diagnosis is often delayed. The finding of Horner syndrome led to imaging of the cervical spine and diagnosis of epidural abscess. Early intervention resulted in resolution of neurologic symptoms and a successful pregnancy outcome.
Connealy
Brendan D
BD
From the Division of Maternal Fetal Medicine, University of Nebraska Medical Center, Omaha, Nebraska; and Division of Maternal Fetal Medicine, University of Colorado Health Sciences Center, Denver, Colorado.
Lovgren
Todd R
TR
Tomich
Paul G
PG
Smith
Carl V
CV
Berg
Teresa G
TG
D000328:Adult; D000900:Anti-Bacterial Agents; D019299:Decompression, Surgical; D020802:Epidural Abscess / Q000382:microbiology* / Q000628:therapy*; D005260:Female; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000382:microbiology* / Q000628:therapy; D013203:Staphylococcal Infections / Q000150:complications / Q000628:therapy*
D000900:Anti-Bacterial Agents