Spontaneous Epidural Abcess in Cervicothoracic Junction: Case Report

Spontaneous spinal epidural abscess (SEA) is an uncommon but potentially fatal and shattering infectious disease. Generally treatment strategy for SEA is antibiotics and surgical decompression. In this report we present a SEA which was located at cervicothoracic region and highlight the importance of correct diagnosis and surgical timing for neurological functional recovery. We report a 65-year-old woman who presented to the emergency department of our hospital with progressive weakness in the arms and legs. The patient's spontaneous breathing had stopped immediately after the emergency admission and she was comatose with quadriplegia. Craniospinal axis magnetic resonance imaging revealed an extradural lesion at the C4-Th2 level with significant compression of the spinal cord. The patient was operated with left C5-Th1 hemilaminectomy and epidural abscess was drained. Staphylococccus aeureus was grown in the abscess culture. Appropriate antibiotherapy was given. Spontaneous breathing started after the operation and quadriplegia partially recorved and 4/5 upper and 2/5 lower extremity quadriparesis was achieved in the early postoperative period. Spinal epidural abscess is a rare disease. Delays in correct diagnosis of SEA might be cause irreversible neurological deficits and potentially fatal. Suspicion and careful clinical evaluation with detailed history and physical and neurological examination is essential in SEA patients