Spinal epidural abscess. Early detection with gadolinium magnetic resonance imaging
A. J. Teman
Department of Neurology, North Shore University Hospital-Cornell University Medical College, Manhasset, NY.
To emphasize the importance of timely diagnosis of spinal epidural abscess,
thirteen patients admitted to a single general hospital are presented. In
10 patients, diagnosis was not appreciated at the time of presentation.
After treatment, four remained paraparetic and three died. Nine patients
had predisposing factors, including seven with infections at sites other
than the spinal canal. Staphylococcus aureus was the predominant organism.
Outcome was equally devastating for the seven patients with acute and the
six patients with chronic infections. Gadolinium-enhanced magnetic
resonance imaging was the most useful diagnostic test, and we recommend
that it be performed promptly in any patient with clinical features
suggesting spinal epidural abscess since early surgical drainage and
appropriate antibiotics may yield a favorable outcome.
