Epidural Abscess

An epidural abscess is usually caused by the spread of infection from elsewhere in the body. The infection may spread either directly or through the bloodstream.

If the abscess is in the head, symptoms may include the following:

• fatigue
• fever
• headache
• hemiplegia, or weakness on the opposite side of the body

The following symptoms can be caused by an epidural abscess in the spine:

• fever
• localized back pain, which may radiate into the buttocks and legs
• loss of bowel or bladder control
• headache and neck pain
• sudden weakness and loss of feeling below the level of the abscess

An epidural abscess usually results from the spread of infection either directly or through the bloodstream. For example, an infection of the nasal sinuses or an open skull fracture can cause an abscess to develop. Factors that increase a person's risk for an abscess include:

• bacterial endocarditis, an infection of the heart
• an implant, such as a pacemaker, that has become infected
• an infected urinary catheter or intravenous line (IV)
• osteomyelitis, or bone infection, especially in the vertebrae of the spine
• a recent sinus infection
• recent surgery
• a tooth abscess
• an upper respiratory infection
• a urinary tract infection
• a weakened immune system as a result of diabetes, HIV, or other immunodeficiency disorders

Some epidural abscesses can be prevented by effective treatment of the infection that causes it. For example, someone with a sinus infection should finish all prescribed antibiotics.

Diagnosis of an epidural abscess begins with a history and physical exam. It may be confirmed with a cranial CT scan or cranial MRI .

If the abscess is small and promptly treated, the person may have no long-term effects. If there is extensive damage to the brain, the person may have cognitive impairments, motor impairments, or other problems.

If untreated, epidural abscesses may continue to grow. This can put pressure on the surrounding nerves, causing them to lose function. It may also cause the abscess to rupture, spilling its contents into the bloodstream. By one means or another, the result of an untreated abscess is often death.

An epidural abscess is not contagious, and poses no risk to others.

Someone with an epidural abscess will be given antibiotics to treat the infection. Surgery is usually performed to remove the infected tissue from the brain or spinal cord.

Antibiotics may cause rash, stomach upset, or allergic reactions. Surgery may be complicated by bleeding, infection, or a reaction to the anesthetic. Surgery may actually spread the infection if all of the infectious organisms are not removed or destroyed.

Recurrent infections may occur if the original source of infection is not completely eliminated. If any infection is noted, it should be identified and treated appropriately. If the person has any impairment from brain damage, he or she may need speech therapy, physical therapy, or occupational therapy.

If there has been significant brain damage, the person may need regular visits to the healthcare professional, to whom any new or worsening symptoms should be reported.