Epidural abscess causes

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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

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

If infection following sinusitis case:

If infection following neurosurgery:

Osteomyelitis of the skull

Spinal Epidural Abscess

References

↑ ^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.
↑ 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.
↑ 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.
↑ 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.
↑ 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.
↑ 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.
↑ 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.
↑ Longo, Dan L. (Dan Louis) (2012). Harrison's principles of internal medici. New York: McGraw-Hill. ISBN 978-0-07-174889-6.
↑ Griffiths DL (1980). "Tuberculosis of the spine: a review". Adv Tuberc Res. 20: 92–110. PMID 7395641.

Template:WH Template:WS

[Darouiche2006-1] 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.

[pmid10447289-2] 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.

[pmid15629340-3] 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.

[pmid10433605-4] 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.

[DannerHartman1987-5] 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.

[pmid1359657-6] 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.

[pmid1359381-7] 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.

[pmid7395641-9] Griffiths DL (1980). "Tuberculosis of the spine: a review". Adv Tuberc Res. 20: 92–110. PMID 7395641.

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