Evaluation of Patients with Spontaneous Spinal Epidural Abscess

Abstract

Purpose: Spontaneous spinal epidural abscess (SSEA) is a rare condition. It generally affects diabetics, immunosuppressed patients, intravenous drug users, and patients with recurrent skin infections or abscesses. If untreated, mortality and morbidity rates are considerably high. The most appropriate treatment is controversial. The classical triad of SSEA consists of pain, fever, and neurological deficits. In our clinical practice, we observed that people with no underlying predisposing factors could also have SSEA, and these patients can apply to the hospital with symptoms such as weight loss, loss of appetite, and general condition disorder as well, apart from the classical triad. The aim of our study is to determine the symptoms other than the classical triad and to contribute to the early diagnosis Materials and Methods: The files of the patients who applied to our tertiary neurosurgery outpatient clinic between January 2015 and December 2018 were scanned, and patients with SSEA were determined. Demographic data of patients, presence of any additional disease, complaints at hospital admission, the time between the onset of the symptoms and diagnosis, magnetic resonance imaging findings, laboratory test results, and prognoses were noted. Results: SSEA was seen in 6 (34/100000) of the patients who applied to our outpatient clinic. The mean age was 54.67±17.06 years. 66.6% (n=4) of them were male. Patients most frequently applied with pain (66.6%), weight loss (50%), and general condition disorder (50%) symptoms. Mortality developed in 33% of the patients, while 66% of the patients recovered completely. Conclusion: The absence of the classical triad in patients with SSEA delayed diagnosis and treatment of patients. If untreated, the disease can be fatal. Early diagnosis and treatment will reduce mortality and morbidity rates.

Keywords

• epidural abscess
• central nervous system infections
• spinal abscess