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| ===Common Causes=== | | ===Common Causes=== |
| Although some infectious 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 most 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><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>
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| ====Intracranial Epidural Abscess====
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| *If [[infection]] following [[sinusitis]] case:
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| :*[[Microaerophile|Microaerophilic organisms]]
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| :*[[Anaerobic]] [[streptococci]]
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| :*Other [[anaerobes]] - [[Propionibacterium]]
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| *If [[infection]] following [[neurosurgery]]:
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| :*[[Staphylococcus aureus]]
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| :*[[Gram-negative bacteria]]
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| *[[Osteomyelitis]] of the [[skull]]
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| ====Spinal Epidural Abscess====
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| *[[Staphylococcus aureus]]
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| *[[MRSA]] (increasing incidence)
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| *[[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>
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| ==Causes by Organ System== | | ==Causes by Organ System== |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
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: intracranially or in the spinal canal. According to the region of infection, some responsible organisms will be shared by both types of abscess however, others will differ, 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 neurosurgical procedures, while in the case of spinal epidural abscess, the most common risk factors are infections of the surrounding tissues and spinal procedures.
Causes
Life Threatening Causes
Life-threatening conditions may result in death or permanent disability within 24 hours if left untreated. Epidural abscess is a life-threatening condition and must be treated as such irrespective of the cause.
Common Causes
Causes by Organ System
| Cardiovascular
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No underlying causes
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| Chemical/Poisoning
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No underlying causes
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| Dental
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No underlying causes
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| Dermatologic
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Coagulase-negative staphylococci, MRSA, Propionibacterium, Sporothrix, Staphylococcus aureus, Staphylococcus epidermidis
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| Drug Side Effect
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No underlying causes
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| Ear Nose Throat
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Mastoiditis, Otitis, Peptostreptococcus species, Sinusitis
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| Endocrine
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No underlying causes
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| Environmental
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Expanded polytetrafluethylene
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| Gastroenterologic
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Aerobic gram-negative bacilli, Dracunculus, Echinococcus, Escherichia coli
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| Genetic
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No underlying causes
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| Hematologic
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Bloodstream infections
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| Iatrogenic
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Anesthetic procedures, Back surgery, Craniotomy, Epidural analgesia, Epidural catheter, Neurosurgery, Recent neurosurgery, Scalp venous catheter, Spinal surgery
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| Infectious Disease
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Aerobic gram-negative bacilli, Anaerobes, Anaerobic streptococci, Bloodstream infections, Bone infections, Candida, Coagulase-negative staphylococci, Dracunculus, Echinococcus, Escherichia coli, Fungi, Gram-negative bacteria, Gram-negative rods, Gram-positive bacilli, Mastoiditis, Microaerophilic organisms, MRSA, Mycobacterium tuberculosis, Osteomyelitis of the skull, Osteomyelitis, Otitis, Parasites, Peptostreptococcus species, Propionibacterium, Pseudomonas aeruginosa, Pyogenic infectious discitis, Sinusitis, Staphylococcus aureus, Staphylococcus epidermidis, Streptococci
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| Musculoskeletal/Orthopedic
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Bone infections, Osteomyelitis of the skull, Osteomyelitis, Pyogenic infectious discitis
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| Neurologic
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No underlying causes
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| Nutritional/Metabolic
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No underlying causes
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| Obstetric/Gynecologic
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No underlying causes
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| Oncologic
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No underlying causes
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| Ophthalmologic
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No underlying causes
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| Overdose/Toxicity
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No underlying causes
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| Psychiatric
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No underlying causes
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| Pulmonary
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Aspergillus species, Mycobacterium tuberculosis, Pseudomonas aeruginosa
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| Renal/Electrolyte
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No underlying causes
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| Rheumatology/Immunology/Allergy
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No underlying causes
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| Sexual
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Candida
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| Trauma
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Head injury, Sporothrix, Trauma
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| Urologic
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No underlying causes
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| Miscellaneous
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Aerobic gram-negative bacilli, Anaerobes, Anaerobic streptococci, Aspergillus species, Bloodstream infections, Candida, Coagulase-negative staphylococci, Dracunculus, Echinococcus, Escherichia coli, Fungi, Gram-negative bacteria, Gram-negative rods, Gram-positive bacilli, Microaerophilic organisms, MRSA, Mycobacterium tuberculosis, Osteomyelitis of the skull, Osteomyelitis, Parasites, Peptostreptococcus species, Pseudomonas aeruginosa, Pyogenic infectious discitis, Sporothrix, Staphylococcus aureus, Staphylococcus epidermidis, Streptococci
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Causes in Alphabetical Order
References