Spinal Epidural Abscess Presented with Sciatica: A Case Report
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Abstract
Spinal Epidural Abscess is a neurological emergency which requires surgical decompression with pus drainage. Delayed diagnosis and treatment may result in disability or death. Some risk factors include diabetes mellitus, Intravenous drug use, chronic alcoholism, AIDS. The classic triad of spinal epidural abscess includes fever, back pain and focal neurological deficit. However, we describe a 65 -year-old man who had well-controlled hypertension and no previous history of back injury, who complained of sciatica pain. Physical examination revealed fever with positive straight leg raising test. The preliminary report of the blood test detected leukocytosis. MRI of thoracolumbar spine showed spinal epidural abscess. The patient underwent surgical drainage combined with antibiotic therapy for 6 weeks. His condition improved without any neurological abnormalities. Pus culture and hemoculture showed Klebsiella pneumoniae. Spinal epidural abscess from Klebsiella pneumoniae can occur in a normal host, even without a prior history of accident. The symptoms may not be specific such as fever and sciatica pain without any other neurological deficit.
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