Spinal Epidural Abscess Presented with Sciatica: A Case Report
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Creator Ratchanee Chansuchai
Title Spinal Epidural Abscess Presented with Sciatica: A Case Report
Publisher Text and Journal Publication
Publication Year 2561
Journal Title Vajira Medical Journal
Journal Vol. 62
Journal No. 1
Keyword Spinal epidural abscess, sciatica pain, Klebsiella pneumoniae
URL Website https://tci-thaijo.org/index.php/VMED
Website title Vajira Medical Journal (วชิรเวชสาร)
ISSN 0125-1252
Abstract Spinal Epidural Abscess is a neurological emergency which requires surgical decompression with pus drainage. Delayed diagnosis and treatment may result in disability or death. The risk factors are diabetes mellitus, Intravenous drug use, chronic alcoholism, AIDS etc. The classic triad of spinal epidural abscess includes fever, back pain and focal neurological deficit. However, we described a 65 -year-old man who had well-controlled hypertension and no previous history of back injury complained with sciatica pain. Physical examination revealed fever with positive straight leg raising test. The preliminary report of the blood test detected leukocytosis. MRI of thoracolumbar spine showed spinal epidural abscess. The patient underwent surgical drainage combined with antibiotic therapy for 6 weeks. His condition improved without any neurological abnormalities. Pus culture and hemoculture showed Klebsiella pneumoniae. Spinal epidural abscess from Klebsiella pneumoniae can occur in normal host, may have no prior history of the accident. The symptoms may not be specific such as fever and sciatica pain without any other neurological deficit.
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