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An epidural abscess is a swelling caused by an infection between the meninges and the bones of the spine or skull. It can cause symptoms such as fever, nausea, vomiting, back pain, paralysis, and weakness. Early diagnosis and treatment are crucial for a better prognosis, and treatment usually involves surgery and antibiotics.
An epidural abscess is a swelling between the spinal cord or skull and the nervous system. This is usually caused by an infection between the meninges, or the membranes covering the brain and spinal cord, and the bones of the spine or skull. About 90% of the time, an epidural abscess is found bordering the spine. The most common causes of abscesses in the head and spine area are infections at the site of the abscess or elsewhere in the body. These infections could be caused by bacteria or fungi, but occasionally an epidural abscess will occur in someone with no visible infection.
If the abscess is between the skull and the brain, it is called an intracranial epidural abscess. This type of abscess causes the typical symptoms of infections such as fever, nausea and vomiting. It also causes headache, lethargy, and pain at the site of the swelling. An intracranial epidural abscess is more likely to occur in patients who have a history of ear infections or sinus infections and can also occur after head surgery or head trauma.
If the site of swelling is somewhere along the spine, it is called a spinal epidural abscess. Spinal abscesses can cause bowel or bladder problems such as incontinence or difficulty urinating. Some patients will also feel back pain, paralysis or weakness. People who have had back surgery or recent bloodstream infections are at higher risk for spinal epidural abscesses.
Anyone who has persistent back pain or headaches with fever, vomiting, and fever, or who has weakness and difficulty moving around should see a doctor. The earlier an epidural abscess is diagnosed and treated, the better the prognosis. If symptoms persist to the point of causing paralysis or severe weakness, however, it could be an indication that significant nerve damage has occurred, and in some cases, the damage is permanent.
If a patient has symptoms of an epidural abscess, a doctor will typically do scans of the head and back area using a computed tomography (CT) or magnetic resonance imaging (MRI) scan. After finding an abscess, your doctor may take samples of it to determine the cause of the infection. Typically, an abscess treatment has two components. Patients have surgery to drain the abscess and relieve pressure on the brain or spinal cord, and take strong antibiotics, usually through an intravenous (IV) line for four to six weeks.
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