Fulminant Spinal Epidural Abscess with Gas

Abstract

Spinal epidural abscess is a medical emergency and is usually secondary to hematogenous spread. The primary focus in most cases is skin or soft tissue and is often associated with vertebral osteomyelitis and paraspinal abscess. The most common predisposing factor is diabetes. Other factors include immunosuppression, spinal surgery or trauma. Epidural abscess with gas is much rarer. We report the case of a 49-year-old diabetic lady with pararenal, paraspinal and epidural abscess containing gas. Pus grew E. coli. Her symptoms and signs were rapidly progressive and fatal despite the emergent evacuation of pus from all planes including the epidural space and institution of appropriate antibiotics. In spite of rapid and early debridement, the overall prognosis may remain grim in case of fulminant infection with gas-forming organisms. It is likely that the ability to control the systemic response to infection is the deciding factor.

Keywords: Abscess, E. coli, emphysematous, epidural, spine

Cite this Article

Rajneesh Misra, Sushil Kumar, Sandeep Sharma, Pankaj Bharadva. Fulminant Spinal Epidural Abscess with Gas. Research and Reviews: Journal of Neuroscience. 2019; 9(3): 24–28p.