Spinal epidural abscess: the importance of early diagnosis and treatment.

OBJECTIVES To remind clinicians of the dangers of delayed diagnosis and the importance of early treatment of spinal epidural abscess. METHODS A review of the literature on spinal epidural abscess and a comparison of the published literature with local experience. RESULTS Imaging with MRI or CT enables early diagnosis of spinal epidural abcess and optimal therapy is surgical evacuation combined with 6-12 weeks (median 8 weeks) of antimicrobial chemotherapy. Clinical features are fever, pain, and focal neurological signs and may be associated with preceding and pre-existing bone or joint disease. The commonest aetiological organism is S aureus. CONCLUSION Early diagnosis and appropriate early antimicrobial chemotherapy with surgery is associated with an excellent prognosis.