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[A case report of epidural abscess due to anaerobic bacteria, producing a mass of gas].

A 54-year-old female was admitted to our hospital on May 8, 1996, for evaluation of fever and headache. Her cerebrospinal fluid showed elevation of the cell count and total protein. The thoracic and lumbar MRIs revealed abnormal gas occupying the epidural space at the sacral level, and extended as high as 9th thoracic level. The gas spread inside the iliopsoas and paraspinal muscles. Anaerobic bacteria such as Bacteroides fragilis and Peptostreptococcus productus were cultured from the spinal fluid and Bacteroides was also detected from the epidural tissues obtained during laminectomy. The infectious source was decubitus extending around the sacral bone. The combination therapy of debridement with peroxide, catheter drainage of epidural abscess, intravenous and intrathecal antibiotics, and laminectomy presented her good outcome. This is a rare case of anaerobic bacterial spinal abscess, showing epidural and intramuscular gas as a prominent feature.