Epidural abscess

Alternative names:

abscess - epidural

Symptoms:

• deep, localized tenderness in the ear, nose, or back (earache, low back pain, nose pain)
• headache
  • all over (generalized)
  • or in a specific area (localized)--particularly in the front of the head
  • persistent
  • progressively worsens

• fever
  • may be slight
  • may be high and accompanied by chills

• excessive sweating
• general discomfort or uneasiness (malaise)
• nausea, vomiting
• pus drainage from the ear may occur if the abscess is caused by an ear infection and the tympanic membrane ruptures
• variable neurologic losses
  • speech difficulty
  • a decrease in sensation of any area of the body
  • weakness or decreased movement of any area of the body
  • vision changes
  • hearing difficulty

• seizures (uncommon)
• pain radiating from the midbody into an extremity (spinal epidural abscess)

Signs and tests:

Examination of the spine by touch and percussion may show localized pain in the spine, which is worsened by examination of the area. Neurologic examination may show focal neurologic deficits (loss of neurologic functions such as movement or sensation) that indicate the location of the abscess. Persistent headache, fever, and/or back pain in a person with a known infection may indicate epidural abscess.

• Head and/or spine X-rays, a head CT scan, or an MRI of the head confirm epidural abscess. Dye may be necessary for a CT scan or an MRI to show a clear picture of the abscess.
• Fluid drained from the abscess during surgery is usually cultured to definitively show the abscess and the causative organism.