Epidural abscess physical examination

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

Overview

Physical examination of patients with epidural abscess is usually remarkable for fever, back pain, and generally well appearance, often contributing to misdiagnosis.

Physical Examination

Physical examination of patients with epidural abscess is usually remarkable for the following:^[1]^[2]^[3]^[4]

General appearance

Patient generally appears complaining of malaise and fever.

Vital signs

HEENT

Back

Back pain

Extremities

Focal pain radiating from back

Neuromuscular

Altered mental status
Seizures
Hemiparesis
Weakness
Altered reflexes
Paresthesia
Paralysis
Spinal cord dysfunction, with sphincter incompetence and sensory and motor deficits
Meningism

References

↑ Darouiche, Rabih O. (2006). “Spinal Epidural Abscess”. New England Journal of Medicine. 355 (19): 2012–2020. doi:10.1056/NEJMra055111. ISSN 0028-4793.
↑ Fountas KN, Duwayri Y, Kapsalaki E, Dimopoulos VG, Johnston KW, Peppard SB; et al. (2004). “Epidural intracranial abscess as a complication of frontal sinusitis: case report and review of the literature”. South Med J. 97 (3): 279–82, quiz 283. PMID 15043336.
↑ Mandell, Gerald L.; Bennett, John E. (John Eugene); Dolin, Raphael. (2010). Mandell, Douglas, and Bennett’s principles and practice of infectious disease. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0-443-06839-9.
↑ Schlossberg, David (2008). Clinical infectious disease. Cambridge New York: Cambridge University Press. ISBN 9780521871129.

[Darouiche2006-1] Darouiche, Rabih O. (2006). “Spinal Epidural Abscess”. New England Journal of Medicine. 355 (19): 2012–2020. doi:10.1056/NEJMra055111. ISSN 0028-4793.

[pmid15043336-2] Fountas KN, Duwayri Y, Kapsalaki E, Dimopoulos VG, Johnston KW, Peppard SB; et al. (2004). “Epidural intracranial abscess as a complication of frontal sinusitis: case report and review of the literature”. South Med J. 97 (3): 279–82, quiz 283. PMID 15043336.

[Mandell-3] Mandell, Gerald L.; Bennett, John E. (John Eugene); Dolin, Raphael. (2010). Mandell, Douglas, and Bennett’s principles and practice of infectious disease. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0-443-06839-9.

[Schlossberg-4] Schlossberg, David (2008). Clinical infectious disease. Cambridge New York: Cambridge University Press. ISBN 9780521871129.

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