Epidural Abscess

An epidural abscess is a collection of pus that has accumulated between the dura and the calvarium or spine. It is rare but can lead to severe neurologic dysfunction or death. There are two main subsets of epidural abscess: spinal epidural abscess (SEA) and intracranial epidural abscess (ICEA). Early diagnosis is key to minimizing complications. Back pain is the most common presentation of SEA, along with spinal tenderness. Treatment requires prolonged hospitalization, surgical drainage in most cases, and long-term antibiotics. Except in rare cases, patients with SEA and ICEA will require hospital admission. In the stable patient, antibiotics should be withheld until culture data can be obtained. If surgical treatment is not readily available, biopsy is often performed to obtain samples for culture before starting antibiotics.