Karaja Saja, Alassaf Shafiq, Assaf Ahed, Tannous Elias, Alassaad Rima, Alassad Ghiath
Faculty of Medicine, Hama University, Hama, Syria.
Faculty of Medicine, Hama University, Hama, Syria.
Int J Surg Case Rep. 2025 Jun;131:111435. doi: 10.1016/j.ijscr.2025.111435. Epub 2025 May 13.
Spinal epidural abscess (SEA) is a rare but severe infection occurring in the epidural space of the spinal cord, increasingly associated with invasive spinal procedures and intravenous drug use. Recognizing and accurately diagnosing SEA is crucial due to its potential neurological impact.
A 51-year-old male presented with urinary and bowel obstruction, right-sided hemiplegia, fever, and jaundice. Neurological examination revealed pronounced deficits, while imaging and cerebrospinal fluid analysis confirmed multiple epidural abscesses. Cultures identified Staphylococcus aureus sensitive to vancomycin and meropenem.
The case underscores the variable presentations and nonspecific symptoms of SEA, highlighting the importance of an accurate medical history and timely imaging for diagnosis. Early intervention with surgical drainage and antibiotic therapy based on culture sensitivity is essential for improving outcomes.
This case emphasizes the need for heightened awareness of SEA, particularly in patients with risk factors, to ensure prompt diagnosis and treatment to prevent irreversible neurological damage.
脊髓硬膜外脓肿（SEA）是一种发生在脊髓硬膜外间隙的罕见但严重的感染，越来越多地与侵入性脊柱手术和静脉药物使用相关。由于其潜在的神经学影响，认识并准确诊断SEA至关重要。
一名51岁男性出现尿路和肠道梗阻、右侧偏瘫、发热和黄疸。神经学检查显示明显缺陷，而影像学和脑脊液分析证实存在多个硬膜外脓肿。培养物鉴定出对万古霉素和美罗培南敏感的金黄色葡萄球菌。
该病例强调了SEA的表现多样和症状不具特异性，突出了准确病史和及时影像学检查对诊断的重要性。基于培养敏感性进行手术引流和抗生素治疗的早期干预对于改善预后至关重要。
本病例强调需要提高对SEA的认识，特别是对有危险因素的患者，以确保及时诊断和治疗，防止不可逆转的神经损伤。
