Acute spinal epidural abscess: a report of two cases, one with autopsy findings

Abstract

Acute spinal epidural abscess is indeed fatal but potentially curable, if recognized before the occurrence of permanent anatomical damage. Early diagnosis and prompt decompression laminectomy may given an encouraging and favorable outcome. On the other hand, an equivalent time delay in recognition of the disease may take the patient's life, or make him paraplegic forever. With a full blown clinical picture of severe back pain, fever, leucocytosis and progressive paralysis the diagnosis is relatively simple and straightforward. However, in a certain number of patients the clinical presentation may be atypical and definitive diagnosis becomes considerably delayed. Early diagnosis of the disease is the most important point in dealing with the acute spinal epidural abscess. There is no single sign or combination of physical signs which is always pathognomonic for acute spinal epidural abscess. To make early diagnosis may not be possible unless one keeps this possibility in mind when examining patients with transverse myelitis, ascending myelitis, or spinal cord compression.