BACKGROUND

Timely diagnosis and prompt management of thoracic epidural abscesses are vital to preventing the onset of irreversible paralysis and death.

CASE DESCRIPTION

A 39-year-old female was managed initially for non-specific chest pain for 10 days (i.e., diagnosis of respiratory tract infection). After she developed paraplegia (0/5 motor function), a T10 sensory level, and acute urinary retention, a thoracic magnetic resonance with contrast revealed a T3-T7 spinal epidural abscess with cord compression. On review of her lab studies revealed a white blood cell count of 11.03 × 10/L and a C-reactive protein level of 122 mg/dL. Following a T3-T7 laminectomy with evacuation of an extradural empyema, she fully recovered.

CONCLUSION

This case report emphasizes the need for early recognition, diagnosis, and treatment of thoracic epidural abscesses that are too often mis-diagnosed as respiratory infections.