Cervical epidural abscess following an Escherichia coli urinary tract infection.
A previously healthy 64-year-old man developed an Escherichia coli spinal epidural abscess (SEA) isolated to the cervical vertebrae posturinary tract infection 9 days previously. He subsequently underwent emergent surgical decompression followed by a prolonged course of intravenous antibiotics. He is symptom free at 1-year follow-up. SEA is an uncommon condition. Even with modern surgical techniques and antimicrobial agents, the mortality remains significant. Intravenous drug use, spinal procedures and medical conditions such as diabetes, Crohn's disease and chronic renal failure are all known risk factors for SEA and the majority of cases are associated with at least one of these risk factors. The case report highlights the importance of maintaining a high index of suspicion for this condition even in patients without established risk factors who present with red flag symptoms: back pain, fever and neurological deficit, as the consequences of a delayed diagnosis can be severe.
National Spinal Injuries Unit, Mater Misericordiae University Hospital, Dublin, Ireland.
Shane C
SC
O'Neill
Joseph F
JF
Baker
Prasad
P
Ellanti
Keith
K
Synnott
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002574:Cervical Vertebrae; D003937:Diagnosis, Differential; D017586:Diskectomy / Q000379:methods; D020802:Epidural Abscess / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D004926:Escherichia coli / Q000302:isolation & purification*; D004927:Escherichia coli Infections / Q000150:complications* / Q000382:microbiology; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D014552:Urinary Tract Infections / Q000150:complications* / Q000382:microbiology
D000900:Anti-Bacterial Agents