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Volume 41, Number 2, April 2008

Successful medical treatment of spinal epidural abscess


Bo-Ren Xiao, Chih-Wei Wang, Jung-Chung Lin, Feng-Yee Chang
Division of Infectious Diseases and Topical Medicine, Department of Internal Medicine and Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

Received: October 9, 2006    Revised: February 7, 2007    Accepted: March 30, 2007   

 

Corresponding author:

Dr. Feng-Yee Chang, M.D., Ph.D., Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Tri-Service General Hospital, Number 325, Section 2, Cheng-Kung Road, Neihu, Taipei 114, Taiwan. E-mail: Dr. Feng-Yee Chang This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
 



 

Methods:

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.



 

Key words:

Drug therapy; Epidural abscess; Treatment outcome


 



 

J Microbiol Immunol Infect. 2008;41:180-182.