"Hot and Achy": A Case of an Extensive Spinal Epidural Abscess

TL;DR

An elderly woman with a fever and back pain was diagnosed with a rare spinal infection, which was successfully treated with antibiotics.

Contribution

This paper presents a rare clinical case emphasizing the importance of early diagnosis of spinal epidural abscesses.

Findings

The patient had an extensive spinal epidural abscess revealed by MRI.

She improved with conservative IV antibiotic treatment.

No neurological deficits were observed during treatment.

Abstract

We present a case of a 94-year-old female who presented to the emergency room with a fever and generalized weakness without an initial obvious source of infection. Throughout admission, she continued to be febrile despite broad-spectrum antibiotics. Several days into admission, the patient complained of severe back pain, necessitating magnetic resonance imaging (MRI) of the entire spine. The imaging revealed an extensive epidural fluid collection consistent with a spinal epidural abscess. Fortunately, she did not have any neurological deficits and was treated conservatively with IV antibiotics with improvement. This case highlights this rare presentation and the importance of early diagnosis and management of spinal epidural abscesses.

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