Epidural abscess
- Infectious complication of:
- endocarditis
- vertebral osteomyelitis
- psoas muscle abscess.
Diagnosis:
- Classic triad of symptoms:
- back pain
- fever
- neurologic deficit.
Management:
- MRI
- Surgical drainage often necessary if:
- lesions > 3cm
- gas present in abscess
- no improvement with medical therapy.
- Treat according to C&S results of blood cultures or CT-guided aspirate of abscess.
Usual Pathogens
S. aureus/MRSA
Enterobacterales
Streptococci
CoNS
P. aeruginosa
Anaerobes
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Vancomycin | 60mg/kg/d IV div q6h | 6 weeks |
| + | ||
| Ceftriaxone | 100mg/kg/d IV div q12h | |
| + | ||
| Metronidazole | 30mg/kg/d IV div q8h |