Spontaneous extensive spinal epidural methicillin-resistant Staphylococcus aureus (MRSA) abscess at the level of the cervical and thoracic area in a 21-year-old female: A case report

Abstract

Spinal epidural abscess is a rare but potentially devastating condition. It usually spans 3 to 4 spinal levels and is associated with patients in an immunocompromised state. We report a case of a 21-year-old Filipino female who presented with high-grade fever, severe nuchal, and upper back pain later associated with progressive ascending numbness and weakness of the lower extremities and bladder and bowel disturbance, related to a furuncle in the right elbow. Contrast-enhanced magnetic resonance imaging showed peripherally enhancing fluid collections in the cervicothoracic paraspinal regions consistent with an extensive epidural abscess. Blood and paravertebral tissue culture were positive for methicillin-resistant Staphylococcus aureus. She underwent a T1-T3 and T5 laminectomy with the evacuation of the abscess followed by an 8-week antibiotic regimen which provide improvement in symptoms. Currently, she is undergoing physical and occupational therapy. To our awareness and with consideration for its rarity, this is the first Filipino case of extensive spinal epidural methicillin-resistant S aureus abscess in an HIV seronegative individual.