Spinal epidural empyema

Br J Neurosurg. 2003 Apr;17(2):196-200. doi: 10.1080/0268869031000108990.

Abstract

Spinal epidural empyema is a very rare entity occurring with an estimated incidence of 1 per 10,000 hospital admissions. This condition has a reputation for presenting as a diagnostic challenge resulting in late diagnosis and delayed treatment. However, the cornerstones of treatment are prompt diagnosis and early treatment to prevent permanent paralysis and high mortality. We present a cluster of nine cases presenting to the neurosurgery unit over a 3-year period and discuss their relevant features in view of the most recent literature. The diagnosis of spinal epidural empyema was made with gadolinium-enhanced MRI in eight of nine cases. Staphylococcus aureus was isolated as the causative pathogen in all cases. All patients were treated with antibiotics. Eight patients had surgery for debridement and spinal decompression. One patient was treated successfully with antibiotics alone.

Publication types

  • Review

MeSH terms

  • Adult
  • Aged
  • Empyema / diagnosis
  • Empyema / microbiology
  • Empyema / therapy*
  • Epidural Abscess / diagnosis
  • Epidural Abscess / microbiology
  • Epidural Abscess / therapy*
  • Female
  • Gadolinium
  • Humans
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Risk Factors
  • Spinal Cord Compression / microbiology
  • Spinal Cord Compression / surgery
  • Spinal Cord Diseases / diagnosis
  • Spinal Cord Diseases / microbiology
  • Spinal Cord Diseases / therapy*
  • Staphylococcal Infections / diagnosis
  • Staphylococcal Infections / therapy*
  • Staphylococcus aureus / isolation & purification

Substances

  • Gadolinium