Spinal Epidural Abscess - Illness Script
Epidemiology:
 - Patients at risk for bacteremia: IVDU, dental abscess, HD catheter, endocarditis, epidural catheter placement
 - Other risk factors: Alcoholism, DM, HIV
Microbiology:
 - Staph aureus most common (63%)
Clinical features:
 - Classic, but rare triad: Fever, spinal pain, neuro deficits
 - Classic progression: Focal severe back pain -5 radiculopathy motor weakness, sensory changes, and bladder/ bowel dysfunction paralysis
Diagnosis:
 - MRI with contrast
 - Locate the source: blood cultures (positive 62%), thorough H&P, other imaging as needed
Treatment:
 - Surgical drainage
 - Antibiotics
Prognosis:
 - 5% mortality
 - Significant numbers have residual neurological deficits including paraplegia

SCVMC Internal Medicine @SCVMCMed

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