Epidural spinal abscesses. Review of a clinical serie

• Published in: Neurología (Barcelona, Spain) Vol. 23; no. 2; p. 85
• Main Authors: Hernández, A González, Fernández, J C López, Pi, O Fabre, Román, M Platero, Toledo, V Araña, Gallego, J Hernández
• Format: Journal Article
• Language: Spanish
• Published: Spain 01-03-2008
• Subjects: Aged; Epidural Abscess - diagnosis; Epidural Abscess - microbiology; Epidural Abscess - physiopathology; Epidural Abscess - therapy; Female; Humans; Male; Middle Aged; Prognosis; Retrospective Studies; Spinal Cord Diseases - diagnosis; Spinal Cord Diseases - microbiology; Spinal Cord Diseases - physiopathology; Spinal Cord Diseases - therapy; Staphylococcal Infections - diagnosis; Staphylococcal Infections - physiopathology; Staphylococcal Infections - therapy; Staphylococcus aureus
• ISSN: 0213-4853

The spinal abscess is an infrequent infectious complication whose diagnosis is often delayed, therefore bringing about significant morbidity and death rates. In the last years, its incidence has raised progressively. The objective of this work is to present the clinical features of a series of spinal abscesses.
The clinical histories of all patients diagnosed of spinal cord abscess were evaluated retrospectively.
We obtained seven cases, with a 5/2 male/female proportion, all subjects being over 50 years old. Incidence was 0.58/10,000 admissions per year. All patients debuted with local pains, but only 6/7 (90%) had fever. Focal neurological signs appeared in all patients within the first 0-5 day-period; they were weakness (86%) and sensitive alterations (43%). The most frequent germ was Staphylococcus aureus ( 5 0%). Diabetes mellitus existed in 5/7 cases (71.5%). Four patients were treated by surgery; three of them (75%) had flaccid motor deficit as sequel and the other died. Medical treatment alone was maintained in 3/7 (43%); two experienced partial improvement without recovery of the motor functions and another died.
Spinal epidural abscess is a rare, although serious, disease. For this reason, we should maintain a high level of suspicion when a patient has spinal or radicular pain associated with systemic symptoms such as fever or deterioration in the general state of health, especially in patients >50 years under weakening situations.