brain, spinal cord, and nerve disorders
Epidural Abscess in the Spine
Introduction
A spinal epidural abscess is an accumulation of pus in the space between the spine and outer layer (dura mater) of tissue covering the spinal cord (epidural space). These abscesses can put pressure on (compress) the spinal cord. Epidural abscesses are often caused by bacteria from another infection in the body. They may cause back pain, which may become severe, and weakness or partial paralysis of the legs, loss of bladder and bowel control, fever, and other serious symptoms. Doctors use magnetic resonance imaging (MRI) to diagnose an epidural abscess in the spinal cord or, if MRI, is unavailable, myelography followed by computed tomography. Doctors treat abscesses with antibiotics, and if the abscess is causing serious problems, they drain it immediately. (See also Overview of Spinal Cord Disorders .) Epidural abscesses in the spinal cord are often caused by another infection, most often in the skin or tissues near the spinal cord. However, sometimes epidural abscesses result from an infection of the heart valves ( Infective Endocarditis ), The bacteria that usually cause these abscesses areStaphylococcus aureus(60%),Escherichia colior other gram-negative bacteria (15%), or streptococci (10%). Occasionally, the abscess is caused by tuberculosis that affects the spine (Pott disease) or injection drug use. In about one third of people, the cause cannot be determined. 