- A rare pyogenic infection of the spinal epidural space:
- 2–25/100,000 admissions
- Most common in thoracic spine, followed by lumbar and cervical
- Focus of infection is present followed by either hematogenous spread (∼50%) or direct extension:
- No focus identified in ∼1/3
- Most common source is skin infection:
- Any pyogenic infection may be source
- Staphylococcus aureus accounts for >50% of cases:
- Many are MRSA
- Streptococcus is second most common
- Haemophilus influenzae, gram-negative bacilli, mycobacteria, anaerobic, coagulase-negative Staphylococcus, fungal, and mixed infections also occur
- Complication of epidural catheter or spinal surgery
- Unusual complication of lumbar puncture (usually follows multiple attempts)
- Children present similar to adults with back pain, fever, and neurologic signs as well as nonspecific systemic symptoms
- Infants may exhibit only fever, irritability, and associated meningitis
- Sphincter disturbance is frequently seen
- Usually secondary to hematogenous spread
- Location and bacteriology similar to adults
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Schaider, Jeffrey J., et al., editors. "Epidural Abscess." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307378/all/Epidural_Abscess.
Epidural Abscess. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307378/all/Epidural_Abscess. Accessed May 29, 2023.
Epidural Abscess. (2016). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (5th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307378/all/Epidural_Abscess
Epidural Abscess [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2023 May 29]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307378/all/Epidural_Abscess.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Epidural Abscess ID - 307378 ED - Barkin,Adam Z, ED - Shayne,Philip, ED - Rosen,Peter, ED - Schaider,Jeffrey J, ED - Barkin,Roger M, ED - Hayden,Stephen R, ED - Wolfe,Richard E, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307378/all/Epidural_Abscess PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -