Epidural Abscess

Overview, Causes, & Risk Factors

An epidural abscess is a walled off area of infection in the epidural space.This is the space between the outermost membrane of the brain or spinal cordand the overlying bone and ligaments.

What is going on in the body?

An epidural abscess is usually caused by the spread of infectionfrom elsewhere in the body. The infection may spread either directly or throughthe bloodstream.

What are the causes and risks of the infection?

An epidural abscess usually results from the spread of infection eitherdirectly or through the bloodstream. For example, an infection of the nasalsinuses or an open skull fracture can cause an abscess to develop. Factors thatincrease a person’s risk for an abscess include:

  • bacterial endocarditis, an infection of the heart
  • an implant, such as a pacemaker, that has become infected
  • an infected urinarycatheter or intravenousline (IV)
  • osteomyelitis, orbone infection, especially in the vertebrae of the spine
  • a recent sinus infection
  • recent surgery
  • a tooth abscess
  • an upper respiratoryinfection
  • a urinary tractinfection
  • a weakened immune system as a result of diabetes, HIV, or other immunodeficiency disorders
  • Symptoms & Signs

    What are the signs and symptoms of the infection?

    If the abscess is in the head, symptoms may include the following:

  • fatigue
  • fever
  • headache
  • hemiplegia, or weakness on the opposite side of the body
  • The following symptoms can be caused by spinal epidural abscesses:

  • fever
  • localized back pain, which may radiate into the buttocks and legs
  • loss of bowel or bladder control
  • headache andneck pain
  • sudden weakness and loss of feeling below the level of the abscess
  • Diagnosis & Tests

    How is the infection diagnosed?

    Diagnosis of an epidural abscess begins with a history andphysical exam. It may be confirmed with a cranial CT scan or cranial MRI.

    Prevention & Expectations

    What can be done to prevent the infection?

    Some epidural abscesses can be prevented by effective treatment ofthe infection that causes it. For example, someone with a sinus infectionshould finish all prescribed antibiotics.

    What are the long-term effects of the infection?

    If the abscess is small and promptly treated, the person may have no long-termeffects. If there is extensive damage to the brain, the person may havecognitive impairments, inability to move about as easily as others\ \limited movement of arms or legs\ \decrease in strength or control of the muscles and bones\ \abnormal or impaired coordination\ \medical condition requiring bed rest\ motorimpairments, or other problems.

    If untreated, epidural abscesses may continue to grow. This can put pressure onthe surrounding nerves, causing them to lose function. It may also cause theabscess to rupture, spilling its contents into the bloodstream. In any case,the result of an untreated abscess is often death.

    What are the risks to others?

    An epidural abscess is not contagious, and poses no risk toothers.

    Treatment & Monitoring

    What are the treatments for the infection?

    Someone with an epidural abscess will be given antibiotics totreat the infection. Surgery is usually performed to remove the infected tissuefrom the brain or spinal cord.

    What are the side effects of the treatments?

    Antibiotics may cause rash, stomach upset, or allergic reactions.Surgery may cause bleeding, infection, or allergic reaction to anesthesia. Surgery may actually spread the infection ifall of the infectious organisms are not removed or destroyed.

    What happens after treatment for the infection?

    Recurrent infections may occur if the original source of infectionis not completely eliminated. If any infection is noted, it should beidentified and treated appropriately. If the person has any impairment frombrain damage, he or she may need speech therapy, physicaltherapy, or occupational therapy.

    How is the infection monitored?

    If there has been significant brain damage, the person may need regular visitswith healthcare providers. Any new or worsening symptoms should be reported tothe provider.

    Article type: xmedgeneral