Epidural abscess causes: Difference between revisions

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__NOTOC__
__NOTOC__
{{Epidural abscess}}
{{Epidural abscess}}
{{CMG}}; {{AE}} {{JS}}
{{CMG}} {{AE}} {{JS}}; {{Ochuko}}; {{AG}}


==Overview==
==Overview==
An epidural abscess is a rare suppurative infection of the [[central nervous system]], a collection of [[pus]] localised in the [[epidural space]], lying outside the [[dura mater]].  It may occur in two different places: [[intracranial space|intracranially]] or in the [[spinal canal]]. According to the region of [[infection]], some causing organisms will be shared by both types of abscess, however, others will be different, mainly because of the risk factors involved in that particular area and the mechanisms of [[infection]]. In the case of ''intracranial epidural abscess'', the most common risk factors are [[sinusitis]] and [[neurosurgery|neurosurgical procedures]], while in the case of ''spinal epidural abscess'', the most common risk factors are [[infections]] of the surrounding tissues and spinal procedures.
Common causes of intracranial epidural abscess include paranasal [[sinusitis]], [[osteomyelitis]] of the skull, and extension of infection from concurrent [[otitis]] or [[mastoiditis]]. Common causes of spinal epidural abscess include spinal instrumentation, [[vascular]] access, and [[IV drug use]]. Irrespective of cause, [[epidural abscess]] is a life-threatening, but treatable, condition.


==Causes==
==Causes==
===Life Threatening Causes===
''[[Staphylococcus aureus]]'' is responsible for almost two thirds of the reported cases.<ref name="Darouiche2006">{{cite journal|last1=Darouiche|first1=Rabih O.|title=Spinal Epidural Abscess|journal=New England Journal of Medicine|volume=355|issue=19|year=2006|pages=2012–2020|issn=0028-4793|doi=10.1056/NEJMra055111}}</ref><ref name="pmid10447289">{{cite journal| author=Rigamonti D, Liem L, Sampath P, Knoller N, Namaguchi Y, Schreibman DL et al.| title=Spinal epidural abscess: contemporary trends in etiology, evaluation, and management. | journal=Surg Neurol | year= 1999 | volume= 52 | issue= 2 | pages= 189-96; discussion 197 | pmid=10447289 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10447289  }} </ref>  Due to the generalized use of [[antibiotics]]  through the years, the number of reported cases of spinal epidural abscess due to [[MRSA]] has increased exponentially, reaching up to 40% of the cases in some institutions, particularly in patients with [[spinal cord|spinal]] or vascular implanted devices.<ref name="Darouiche2006">{{cite journal|last1=Darouiche|first1=Rabih O.|title=Spinal Epidural Abscess|journal=New England Journal of Medicine|volume=355|issue=19|year=2006|pages=2012–2020|issn=0028-4793|doi=10.1056/NEJMra055111}}</ref> Other less common, but still important organisms are:<ref name="Darouiche2006">{{cite journal|last1=Darouiche|first1=Rabih O.|title=Spinal Epidural Abscess|journal=New England Journal of Medicine|volume=355|issue=19|year=2006|pages=2012–2020|issn=0028-4793|doi=10.1056/NEJMra055111}}</ref><ref name="pmid15629340">{{cite journal| author=Pereira CE, Lynch JC| title=Spinal epidural abscess: an analysis of 24 cases. | journal=Surg Neurol | year= 2005 | volume= 63 Suppl 1 | issue= | pages= S26-9 | pmid=15629340 | doi=10.1016/j.surneu.2004.09.021 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15629340 }} </ref><ref name="pmid10433605">{{cite journal| author=Chowfin A, Potti A, Paul A, Carson P| title=Spinal epidural abscess after tattooing. | journal=Clin Infect Dis | year= 1999 | volume= 29 | issue= 1 | pages= 225-6 | pmid=10433605 | doi=10.1086/520174 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prli**''[[Staphylococcus epidermidis]]''}}</ref>
Subdural empyema is a life-threatening condition and must be treated as such irrespective of the causes. Life-threatening conditions may result in death or permanent disability within 24 hours if left untreated.
*''[[Escherichia coli]]''
 
*''[[Pseudomonas aeruginosa]]''
===Common Causes===
*[[Anaerobic bacteria]]
Although some causing organisms might be responsible for either type of epidural abscess, others are more common of one of those. Therefore, it is important to specify the more common causes of each epidural abscess, in order for the physician to start proper therapy as early as possible. <ref name="Darouiche2006">{{cite journal|last1=Darouiche|first1=Rabih O.|title=Spinal Epidural Abscess|journal=New England Journal of Medicine|volume=355|issue=19|year=2006|pages=2012–2020|issn=0028-4793|doi=10.1056/NEJMra055111}}</ref><ref name="DannerHartman1987">{{cite journal|last1=Danner|first1=R. L.|last2=Hartman|first2=B. J.|title=Update of Spinal Epidural Abscess: 35 Cases and Review of the Literature|journal=Clinical Infectious Diseases|volume=9|issue=2|year=1987|pages=265–274|issn=1058-4838|doi=10.1093/clinids/9.2.265}}</ref><ref name="pmid1359657">{{cite journal| author=Nussbaum ES, Rigamonti D, Standiford H, Numaguchi Y, Wolf AL, Robinson WL| title=Spinal epidural abscess: a report of 40 cases and review. | journal=Surg Neurol | year= 1992 | volume= 38 | issue= 3 | pages= 225-31 | pmid=1359657 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1359657 }} </ref>
*[[Mycobacteria]]
 
*[[Fungi]]
====Intracranial Epidural Abscess====
*[[Parasites]]
*If [[infection]] following [[sinusitis]] case:
:*[[Microaerophile|Microaerophilic organisms]]
 
:*[[Anaerobic]] [[streptococci]]
:*Other [[anaerobes]] - [[Propionibacterium]]
*If [[infection]] following [[neurosurgery]]:
:*[[Staphylococcus aureus]]
:*[[Gram-negative bacteria]]
*[[Osteomyelitis]] of the [[skull]]
 
====Spinal Epidural Abscess====
*[[Staphylococcus aureus]]
*[[MRSA]] (increasing incidence)
*[[Mycobacterium tuberculosis]] (in some developing countries) <ref name="pmid7395641">{{cite journal| author=Griffiths DL| title=Tuberculosis of the spine: a review. | journal=Adv Tuberc Res | year= 1980 | volume= 20 | issue= | pages= 92-110 | pmid=7395641 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7395641  }} </ref>


==Causes by Organ System==
==Causes by Organ System==
{|style="width:82%; height:100px" border="1"
{|style="width:82%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" |No underlying causes
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" |[[Endocarditis]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
Line 44: Line 30:
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
| '''Dermatologic'''
|bgcolor="Beige"|  [[Coagulase-negative Staphylococcus|Coagulase-negative staphylococci]], [[MRSA]], [[Propionibacterium]], [[Sporotrichosis|Sporothrix]], [[Staphylococcus aureus]], [[Staphylococcus epidermidis]]
|bgcolor="Beige"|  No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
Line 52: Line 38:
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
| '''Ear Nose Throat'''
|bgcolor="Beige"| [[Mastoiditis]], [[Otitis]], [[Peptostreptococcus|Peptostreptococcus species]], [[Sinusitis]]
|bgcolor="Beige"| [[Cholesteatoma]], [[mastoiditis]], [[otitis]], [[sinusitis]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
Line 60: Line 46:
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Environmental'''
| '''Environmental'''
|bgcolor="Beige"| Expanded polytetrafluethylene   
|bgcolor="Beige"| No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
| '''Gastroenterologic'''
|bgcolor="Beige"| [[Aerobic]] [[gram-negative]] [[bacilli]], [[Dracunculus]], [[Echinococcus]], [[Escherichia coli]]
|bgcolor="Beige"| No underlying causes 
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
Line 72: Line 58:
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
| '''Hematologic'''
|bgcolor="Beige"| [[Bloodstream]] [[infections]]
|bgcolor="Beige"| [[Bloodstream infection]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
| '''Iatrogenic'''
|bgcolor="Beige"| [[Anesthesia|Anesthetic procedures]], [[Vertebral column|Back]] [[surgery]], [[Craniotomy]], [[Epidural analgesia]], [[Epidural catheter]], [[Neurosurgery]], Recent [[neurosurgery]], [[Scalp]] [[venous]] [[catheter]], [[Vertebral column|Spinal]] [[surgery]]
|bgcolor="Beige"| [[anesthesia|Anesthetic procedures]], [[surgery|back surgery]], [[craniotomy]], [[epidural analgesia]], [[epidural catheter]], [[neurosurgery]], [[post-surgical infections]], [[intravenous therapy|scalp venous catheter]], [[surgery|spinal surgery]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
| '''Infectious Disease'''
|bgcolor="Beige"| [[Aerobic]] [[gram-negative]] [[bacilli]], [[Anaerobes]], [[Anaerobic]] [[streptococci]], [[Bloodstream]] [[infections]], [[Bone]] [[infections]], [[Candida]], [[Coagulase-negative Staphylococcus|Coagulase-negative staphylococci]], [[Dracunculus]], [[Echinococcus]], [[Escherichia coli]], [[Fungi]], [[Gram-negative bacteria]], [[Gram-negative]] [[Rod cell|rods]], [[Gram-positive]] [[bacilli]], [[Mastoiditis]], [[Microaerophile|Microaerophilic organisms]], [[MRSA]], [[Mycobacterium tuberculosis]], [[Osteomyelitis]] of the [[skull]], [[Osteomyelitis]], [[Otitis]], [[Parasites]], [[Peptostreptococcus|Peptostreptococcus species]], [[Propionibacterium]], [[Pseudomonas aeruginosa]], [[Pyogenic]] [[infectious]] [[discitis]], [[Sinusitis]], [[Staphylococcus aureus]], [[Staphylococcus epidermidis]], [[Streptococci]]
|bgcolor="Beige"| [[gram-negative bacteria|Aerobic gram-negative bacilli]], [[anaerobes]], [[streptococcus|anaerobic streptococci]], [[aspergillus]], [[blastomycosis]], [[bloodstream infection]], [[bone infections]], [[candida]], [[staphylococcus|coagulase-negative staphylococci]], [[dracunculus]], [[echinococcus]], [[encephalitis]], [[escherichia coli]], [[fungi]], [[gram-negative bacilli]], [[gram-negative bacteria]], [[gram-positive bacteria|gram-positive bacilli]], [[HIV]], [[mastoiditis]], [[meningitis]], [[microaerophile|microaerophilic organisms]], [[MRSA]], [[mycobacterium tuberculosis]], [[osteomyelitis]], [[otitis]], [[parasites]], [[peptostreptococcus]], [[post-surgical infections]], [[propionibacterium]], [[pseudomonas aeruginosa]], [[discitis|pyogenic infectious discitis]], [[sinusitis]], [[sporotrichosis|sporothrix]], [[staphylococcus aureus]], [[staphylococcus epidermidis]], [[streptococci]]  
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
| '''Musculoskeletal/Orthopedic'''
|bgcolor="Beige"| [[Bone]] [[infections]], [[Osteomyelitis]] of the [[skull]], [[Osteomyelitis]], [[Pyogenic]] [[infectious]] [[discitis]]
|bgcolor="Beige"| [[Bone infections]], [[osteomyelitis]], [[discitis|pyogenic infectious discitis]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
| '''Neurologic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Encephalitis]], [[head injury]], [[meningitis]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
Line 116: Line 102:
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
| '''Pulmonary'''
|bgcolor="Beige"| [[Aspergillus|Aspergillus species]], [[Mycobacterium tuberculosis]], [[Pseudomonas aeruginosa]]
|bgcolor="Beige"| [[Mycobacterium tuberculosis]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
Line 124: Line 110:
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Rheumatology/Immunology/Allergy'''
| '''Rheumatology/Immunology/Allergy'''
|bgcolor="Beige"|No underlying causes
|bgcolor="Beige"|[[Immunocompromised host]], [[CD4|Low CD4+ cell count]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Sexual'''
| '''Sexual'''
|bgcolor="Beige"| [[Candida]]
|bgcolor="Beige"| No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Trauma'''
| '''Trauma'''
|bgcolor="Beige"| [[Head injury]], [[Sporotrichosis|Sporothrix]], [[Trauma]]
|bgcolor="Beige"| [[Head injury]], [[motor vehicle accident|road traffic accidents]], [[trauma]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
Line 140: Line 126:
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
| '''Miscellaneous'''
|bgcolor="Beige"| [[Aerobic]] [[gram-negative]] [[bacilli]], [[Anaerobes]], [[Anaerobic]] [[streptococci]], [[Aspergillus|Aspergillus species]], [[Bloodstream]] [[infections]], [[Candida]], [[Coagulase-negative Staphylococcus|Coagulase-negative staphylococci]], [[Dracunculus]], [[Echinococcus]], [[Escherichia coli]], [[Fungi]], [[Gram-negative bacteria]], [[Gram-negative]] [[Rod cell|rods]], [[Gram-positive]] [[bacilli]], [[Microaerophile|Microaerophilic organisms]], [[MRSA]], [[Mycobacterium tuberculosis]], [[Osteomyelitis]] of the [[skull]], [[Osteomyelitis]], [[Parasites]], [[Peptostreptococcus|Peptostreptococcus species]], [[Pseudomonas aeruginosa]], [[Pyogenic]] [[infectious]] [[discitis]], [[Sporotrichosis|Sporothrix]], [[Staphylococcus aureus]], [[Staphylococcus epidermidis]], [[Streptococci]]
|bgcolor="Beige"| [[surgery|Back surgery]]
|-
|-
|}
|}
===Causes in Alphabetical Order===
===Causes in Alphabetical Order===
{{col-begin|width=80%}}
{{columns-list|2|
{{col-break|width=33%}}
*[[gram-negative bacteria|Aerobic gram-negative bacilli]]
*[[Aerobic]] [[gram-negative]] [[bacilli]]
*[[Anaerobes]]
*[[Anaerobes]]
*[[Anaerobic]] [[streptococci]]
*[[streptococcus|Anaerobic streptococci]]
*[[Anesthesia|Anesthetic procedures]]
*[[anesthesia|Anesthetic procedures]]
*[[Aspergillus|Aspergillus species]]
*[[Aspergillus]]  
*[[Vertebral column|Back]] [[surgery]]
*[[surgery|Back surgery]]
*[[Bloodstream]] [[infections]]
*[[Blastomycosis]]  
*[[Bone]] [[infections]]
*[[Bloodstream infection]]  
*[[Bone infections]]
*[[Candida]]
*[[Candida]]
*[[Coagulase-negative Staphylococcus|Coagulase-negative staphylococci]]
*[[Cholesteatoma]]
*[[staphylococcus|Coagulase-negative staphylococci]]
*[[Craniotomy]]
*[[Craniotomy]]
*[[Dracunculus]]
*[[Dracunculus]]
*[[Echinococcus]]
*[[Echinococcus]]
*[[Encephalitis]]
*[[Epidural analgesia]]
*[[Epidural analgesia]]
*[[Epidural catheter]]
*[[Epidural catheter]]  
{{col-break|width=33%}}
*[[Escherichia coli]]
*[[Escherichia coli]]
*[[Expanded polytetrafluethylene]]
*[[Fungi]]
*[[Fungi]]
*[[Gram-negative bacilli]]
*[[Gram-negative bacteria]]
*[[Gram-negative bacteria]]
*[[Gram-negative]] [[Rod cell|rods]]
*[[gram-positive bacteria|Gram-positive bacilli]]  
*[[Gram-positive]] [[bacilli]]
*[[Head injury]]  
*[[Head injury]]
*[[HIV]]  
*[[Immunocompromised host]]
*[[CD4|Low CD4+ cell count]]
*[[Mastoiditis]]
*[[Mastoiditis]]
*[[Microaerophile|Microaerophilic organisms]]
*[[Meningitis]]
*[[microaerophile|Microaerophilic organisms]]
*[[MRSA]]
*[[MRSA]]
*[[Mycobacterium tuberculosis]]
*[[Mycobacterium tuberculosis]]
*[[Neurosurgery]]
*[[Neurosurgery]]  
*[[Osteomyelitis]]
*[[Osteomyelitis]]  
*[[Osteomyelitis]] of the [[skull]]
*[[Otitis]]
*[[Otitis]]
{{col-break|width=33%}}
*[[Parasites]]
*[[Parasites]]
*[[Peptostreptococcus|Peptostreptococcus species]]
*[[Peptostreptococcus]]
*[[Propionibacterium]]
*[[Post-surgical infections]]
*[[Propionibacterium]]  
*[[Pseudomonas aeruginosa]]
*[[Pseudomonas aeruginosa]]
*[[Pyogenic]] [[infectious]] [[discitis]]
*[[discitis|Pyogenic infectious discitis]]
*Recent [[neurosurgery]]
*[[motor vehicle accident|Road traffic accidents]]  
*[[Scalp]] [[venous]] [[catheter]]
*[[intravenous therapy|Scalp venous catheter]]
*[[Sinusitis]]
*[[Sinusitis]]  
*Spinal [[surgery]]
*[[surgery|Spinal surgery]]
*[[Sporotrichosis|Sporothrix]]
*[[sporotrichosis|Sporothrix]]
*[[Staphylococcus aureus]]
*[[Staphylococcus aureus]]
*[[Staphylococcus epidermidis]]
*[[Staphylococcus epidermidis]]  
*[[Streptococci]]
*[[Streptococci]]
*[[Trauma]]
*[[Trauma]]
{{col-end}}
}}
===Causes of Epidural Abscess Bases on Classification===
Although some infectious organisms might be responsible for either type of [[epidural abscess]], others are more common of one of those.<ref name="Darouiche2006">{{cite journal|last1=Darouiche|first1=Rabih O.|title=Spinal Epidural Abscess|journal=New England Journal of Medicine|volume=355|issue=19|year=2006|pages=2012–2020|issn=0028-4793|doi=10.1056/NEJMra055111}}</ref><ref name="DannerHartman1987">{{cite journal|last1=Danner|first1=R. L.|last2=Hartman|first2=B. J.|title=Update of Spinal Epidural Abscess: 35 Cases and Review of the Literature|journal=Clinical Infectious Diseases|volume=9|issue=2|year=1987|pages=265–274|issn=1058-4838|doi=10.1093/clinids/9.2.265}}</ref><ref name="pmid1359657">{{cite journal| author=Nussbaum ES, Rigamonti D, Standiford H, Numaguchi Y, Wolf AL, Robinson WL| title=Spinal epidural abscess: a report of 40 cases and review. | journal=Surg Neurol | year= 1992 | volume= 38 | issue= 3 | pages= 225-31 | pmid=1359657 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1359657  }} </ref><ref name="pmid1359381">{{cite journal| author=Darouiche RO, Hamill RJ, Greenberg SB, Weathers SW, Musher DM| title=Bacterial spinal epidural abscess. Review of 43 cases and literature survey. | journal=Medicine (Baltimore) | year= 1992 | volume= 71 | issue= 6 | pages= 369-85 | pmid=1359381 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1359381  }} </ref><ref>{{Cite book  | last1 = Longo | first1 = Dan L. (Dan Louis) | title = Harrison's principles of internal medici | date = 2012 | publisher = McGraw-Hill | location = New York | isbn = 978-0-07-174889-6 | pages =  }}</ref><ref name="pmid7395641">{{cite journal| author=Griffiths DL| title=Tuberculosis of the spine: a review. | journal=Adv Tuberc Res | year= 1980 | volume= 20 | issue=  | pages= 92-110 | pmid=7395641 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7395641  }} </ref>
====Intracranial Epidural Abscess====
*If [[infection]] following [[sinusitis]] case:
:*[[Microaerophile|Microaerophilic organisms]]
:*[[streptococci|Anaerobic streptococci]]
:*[[Propionibacterium]]
:*Other [[anaerobic]] bacteria and fungi
*If [[infection]] following [[neurosurgery]]:
:*''[[Staphylococcus aureus]]''
:*[[Gram-negative bacteria]]
*[[osteomyelitis|Osteomyelitis of the skull]]
 
====Spinal Epidural Abscess====
*''[[Staphylococcus aureus]]''
*[[MRSA]]
*''[[Mycobacterium tuberculosis]]''


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
{{WH}}
{{WS}}


[[Category:Wikinfect]]
[[Category:Infectious disease]]
[[Category:Disease]]
[[Category:Disease]]
[[Category:Neurology]]
[[Category:Neurology]]
[[Category:Primary care]]
[[Category:Crowdiagnosis]]

Latest revision as of 21:35, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]; Ogheneochuko Ajari, MB.BS, MS [3]; Anthony Gallo, B.S. [4]

Overview

Common causes of intracranial epidural abscess include paranasal sinusitis, osteomyelitis of the skull, and extension of infection from concurrent otitis or mastoiditis. Common causes of spinal epidural abscess include spinal instrumentation, vascular access, and IV drug use. Irrespective of cause, epidural abscess is a life-threatening, but treatable, condition.

Causes

Staphylococcus aureus is responsible for almost two thirds of the reported cases.[1][2] Due to the generalized use of antibiotics through the years, the number of reported cases of spinal epidural abscess due to MRSA has increased exponentially, reaching up to 40% of the cases in some institutions, particularly in patients with spinal or vascular implanted devices.[1] Other less common, but still important organisms are:[1][3][4]

Causes by Organ System

Cardiovascular Endocarditis
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect No underlying causes
Ear Nose Throat Cholesteatoma, mastoiditis, otitis, sinusitis
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic No underlying causes
Genetic No underlying causes
Hematologic Bloodstream infection
Iatrogenic Anesthetic procedures, back surgery, craniotomy, epidural analgesia, epidural catheter, neurosurgery, post-surgical infections, scalp venous catheter, spinal surgery
Infectious Disease Aerobic gram-negative bacilli, anaerobes, anaerobic streptococci, aspergillus, blastomycosis, bloodstream infection, bone infections, candida, coagulase-negative staphylococci, dracunculus, echinococcus, encephalitis, escherichia coli, fungi, gram-negative bacilli, gram-negative bacteria, gram-positive bacilli, HIV, mastoiditis, meningitis, microaerophilic organisms, MRSA, mycobacterium tuberculosis, osteomyelitis, otitis, parasites, peptostreptococcus, post-surgical infections, propionibacterium, pseudomonas aeruginosa, pyogenic infectious discitis, sinusitis, sporothrix, staphylococcus aureus, staphylococcus epidermidis, streptococci
Musculoskeletal/Orthopedic Bone infections, osteomyelitis, pyogenic infectious discitis
Neurologic Encephalitis, head injury, meningitis
Nutritional/Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic No underlying causes
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary Mycobacterium tuberculosis
Renal/Electrolyte No underlying causes
Rheumatology/Immunology/Allergy Immunocompromised host, Low CD4+ cell count
Sexual No underlying causes
Trauma Head injury, road traffic accidents, trauma
Urologic No underlying causes
Miscellaneous Back surgery

Causes in Alphabetical Order

The unnamed parameter 2= is no longer supported. Please see the documentation for {{columns-list}}.
2

Causes of Epidural Abscess Bases on Classification

Although some infectious organisms might be responsible for either type of epidural abscess, others are more common of one of those.[1][5][6][7][8][9]

Intracranial Epidural Abscess

Spinal Epidural Abscess

References

  1. ↑ 1.0 1.1 1.2 1.3 Darouiche, Rabih O. (2006). "Spinal Epidural Abscess". New England Journal of Medicine. 355 (19): 2012–2020. doi:10.1056/NEJMra055111. ISSN 0028-4793.
  2. ↑ Rigamonti D, Liem L, Sampath P, Knoller N, Namaguchi Y, Schreibman DL; et al. (1999). "Spinal epidural abscess: contemporary trends in etiology, evaluation, and management". Surg Neurol. 52 (2): 189–96, discussion 197. PMID 10447289.
  3. ↑ Pereira CE, Lynch JC (2005). "Spinal epidural abscess: an analysis of 24 cases". Surg Neurol. 63 Suppl 1: S26–9. doi:10.1016/j.surneu.2004.09.021. PMID 15629340.
  4. ↑ Chowfin A, Potti A, Paul A, Carson P (1999). %5b%5bStaphylococcus epidermidis%5d%5d "Spinal epidural abscess after tattooing" Check |url= value (help). Clin Infect Dis. 29 (1): 225–6. doi:10.1086/520174. PMID 10433605.
  5. ↑ Danner, R. L.; Hartman, B. J. (1987). "Update of Spinal Epidural Abscess: 35 Cases and Review of the Literature". Clinical Infectious Diseases. 9 (2): 265–274. doi:10.1093/clinids/9.2.265. ISSN 1058-4838.
  6. ↑ Nussbaum ES, Rigamonti D, Standiford H, Numaguchi Y, Wolf AL, Robinson WL (1992). "Spinal epidural abscess: a report of 40 cases and review". Surg Neurol. 38 (3): 225–31. PMID 1359657.
  7. ↑ Darouiche RO, Hamill RJ, Greenberg SB, Weathers SW, Musher DM (1992). "Bacterial spinal epidural abscess. Review of 43 cases and literature survey". Medicine (Baltimore). 71 (6): 369–85. PMID 1359381.
  8. ↑ Longo, Dan L. (Dan Louis) (2012). Harrison's principles of internal medici. New York: McGraw-Hill. ISBN 978-0-07-174889-6.
  9. ↑ Griffiths DL (1980). "Tuberculosis of the spine: a review". Adv Tuberc Res. 20: 92–110. PMID 7395641.

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